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Long-term follow-up of high-dose treatment with autologous haematopoietic progenitor cell support in 693 patients with follicular lymphoma: an EBMT registry study

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Montoto, S. Ferrant, Augustin [UCL] Canals, C. Rohatiner, A. Z. S. Taghipour, G. Goldstone, A. H.

To evaluate the outcome of a large series of patients who received high-dose treatment (HDT) for follicular lymphoma (FL), 693 patients undergoing HDT (total-body irradiation (TBI)containing regimen: 58%; autologous bone marrow (BM)/ peripheral blood progenitor cells (PBPCs): 378/ 285 patients) were included in the study. A total of 375 patients (54%) developed recurrent lymphoma, 10-year progression-free survival (PFS) being 31%. On multivariate analysis, younger age (P = 0.003) and HDT in first complete remission (CR1) (P < 0.001) correlated with longer PFS. With a median follow-up of 10.3 years, 330 patients died. Ten-year overall survival (OS) from HDT was 52%. Shorter OS was associated on multivariate analysis with older age (P < 0.001), chemoresistant disease (P < 0.001), BM+PBPC as source of stem cells (P = 0.007) and TBI-containing regimens (P = 0.004). Thirty-nine patients developed secondary myelodysplastic syndrome/ acute myeloid leukaemia (MDS/ AML), in 34 cases having received TBI as the conditioning regimen. The 5-year non-relapse mortality (NRM) was 9%. On multivariate analysis, older age (P < 0.001), refractory disease (P < 0.001) and TBI (P = 0.04) were associated with a higher NRM. This long follow-up study shows a plateau in the PFS curve, suggesting that a selected group of patients might be cured with HDT. On the downside, TBI-containing regimens are associated with a negative impact on survival.

Document type Article de périodique (Journal article) – Article de recherche
Publication date 2007
Language Anglais
Journal information "Leukemia" - Vol. 21, no. 11, p. 2324-2331 (2007)
Peer reviewed yes
Publisher Nature Publishing Group (London)
issn 0887-6924
e-issn 1476-5551
Publication status Publié
Affiliation UCL - Cliniques universitaires Saint-Luc
Keywords high-dose therapy ; autologous stem cell ; follicular lymphoma
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Bibliographic reference Montoto, S. ; Ferrant, Augustin ; Canals, C. ; Rohatiner, A. Z. S. ; Taghipour, G. ; et. al. Long-term follow-up of high-dose treatment with autologous haematopoietic progenitor cell support in 693 patients with follicular lymphoma: an EBMT registry study. In: Leukemia, Vol. 21, no. 11, p. 2324-2331 (2007)
Permanent URL http://hdl.handle.net/2078.1/37269