Total Body Irradiation Is Safe and Similarly Effective as Chemotherapy-Only Conditioning in Autologous Stem Cell Transplantation for Mantle Cell Lymphoma

被引:10
作者
Tseng, Yolanda D. [1 ]
Stevenson, Philip A. [2 ]
Cassaday, Ryan D. [3 ,4 ]
Cowan, Andrew [4 ,5 ]
Till, Brian G. [4 ,5 ]
Shadman, Mazyar [4 ,5 ]
Graf, Solomon A. [4 ,5 ]
Ermoian, Ralph [1 ]
Smith, Stephen D. [4 ,5 ]
Holmberg, Leona A. [4 ,5 ]
Press, Oliver W. [4 ,5 ]
Gopal, Ajay K. [4 ,5 ]
机构
[1] Univ Washington, Dept Radiat Oncol, 1959 NE Pacific St,Box 356043, Seattle, WA 98195 USA
[2] Fred Hutchinson Canc Res Ctr, Clin Stat Div, 1124 Columbia St, Seattle, WA 98104 USA
[3] Univ Washington, Dept Med, Div Hematol, Seattle, WA 98195 USA
[4] Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA
[5] Univ Washington, Dept Med, Div Med Oncol, Seattle, WA USA
关键词
Autologous transplantation; Mantle cell lymphoma; Total body irradiation; BEAM; HIGH-DOSE CYTARABINE; MCL YOUNGER; OUTCOMES; THERAPY; REGIMEN; TRIAL; TBI;
D O I
10.1016/j.bbmt.2017.10.029
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Autologous stem cell transplant (ASCT) consolidation has become a standard approach for patients with mantle cell lymphoma (MCL), yet there is little consensus on the role of total body irradiation (TBI) as part of high dose transplantation conditioning. We analyzed 75 consecutive patients with MCL who underwent ASCT at our institution between 2001 and 2011 with either TBI-based (n = 43) or carmustine, etoposide, cytarabine, melphalan (BEAM; n = 32) high-dose conditioning. Most patients (97%) had chemosensitive disease and underwent transplantation in first remission (89%). On univariate analysis, TBI conditioning was associated with a trend toward improved PFS (hazard ratio [HR],.53; 95% confidence interval [CI],.28-1.00; P = .052) and similar OS (HR,.59; 95% CI,.26-135; P = .21), with a median follow-up of 63 years in the TBI group and 6.6 years in the BEAM group. The 5-year PFS was 66% in the TBI group versus 52% in the BEAM group; OS was 82% versus 68%, respectively. However, on multivariate analysis, TBI-based conditioning was not significantly associated with PFS (HR,.57; 95% CI.24-1.34; P = .20), after controlling for age, disease status at ASCT, and receipt of post transplantation rituximab maintenance. Likewise, early toxicity, nonrelapse mortality, and secondary malignancies were similar in the 2 groups. Our data suggest that both TBI and BEAM-based conditioning regimens remain viable conditioning options for patients with MCL undergoing ASCT. (C) 2017 American Society for Blood and Marrow Transplantation.
引用
收藏
页码:282 / 287
页数:6
相关论文
共 20 条
[1]  
[Anonymous], 2017, CLIN PRACT GUID ONC
[2]  
Aref A, 1999, RADIAT ONCOL INVESTI, V7, P186
[3]   An upward trend in the age-specific incidence patterns for mantle cell lymphoma in the USA [J].
Aschebrook-Kilfoy, Briseis ;
Caces, Donne Bennett D. ;
Ollberding, Nicholas J. ;
Smith, Sonali M. ;
Chiu, Brian C. -H. .
LEUKEMIA & LYMPHOMA, 2013, 54 (08) :1677-1683
[4]   High-dose CD20-targeted radioimmunotherapy-based autologous transplantation improves outcomes for persistent mantle cell lymphoma [J].
Cassaday, Ryan D. ;
Stevenson, Philip A. ;
Gooley, Theodore A. ;
Chauncey, Thomas R. ;
Pagel, John M. ;
Rajendran, Joseph ;
Till, Brian G. ;
Philip, Mary ;
Orozco, Johnnie J. ;
Bensinger, William I. ;
Holmberg, Leona A. ;
Shustov, Andrei R. ;
Green, Damian J. ;
Smith, Stephen D. ;
Libby, Edward N. ;
Maloney, David G. ;
Press, Oliver W. ;
Gopal, Ajay K. .
BRITISH JOURNAL OF HAEMATOLOGY, 2015, 171 (05) :788-797
[5]   RB but not R-HCVAD is a feasible induction regimen prior to auto-HCT in frontline MCL: results of SWOG Study S1106 [J].
Chen, Robert W. ;
Li, Hongli ;
Bernstein, Steven H. ;
Kahwash, Samir ;
Rimsza, Lisa M. ;
Forman, Stephen J. ;
Constine, Louis ;
Shea, Thomas C. ;
Cashen, Amanda F. ;
Blum, Kristie A. ;
Fenske, Timothy S. ;
Barr, Paul M. ;
Phillips, Tycel ;
Leblanc, Michael ;
Fisher, Richard I. ;
Cheson, Bruce D. ;
Smith, Sonali M. ;
Faham, Malek ;
Wilkins, Jennifer ;
Leonard, John P. ;
Kahl, Brad S. ;
Friedberg, Jonathan W. .
BRITISH JOURNAL OF HAEMATOLOGY, 2017, 176 (05) :759-769
[6]   Impact of Conditioning Regimen on Outcomes for Patients with Lymphoma Undergoing High-Dose Therapy with Autologous Hematopoietic Cell Transplantation [J].
Chen, Yi-Bin ;
Lane, Andrew A. ;
Logan, Brent R. ;
Zhu, Xiaochun ;
Akpek, Goerguen ;
Aljurf, Mahmoud. D. ;
Artz, Andrew S. ;
Bredeson, Christopher N. ;
Cooke, Kenneth R. ;
Ho, Vincent T. ;
Lazarus, Hillard M. ;
Olsson, Richard F. ;
Saber, Wael ;
McCarthy, Philip L. ;
Pasquini, Marcelo C. .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2015, 21 (06) :1046-1053
[7]   Revised response criteria for malignant lymphoma [J].
Cheson, Bruce D. ;
Pfistner, Beate ;
Juweid, Malik E. ;
Gascoyne, Randy D. ;
Specht, Lena ;
Horning, Sandra J. ;
Coiffier, Bertrand ;
Fisher, Richard I. ;
Hagenbeek, Anton ;
Zucca, Emanuele ;
Rosen, Steven T. ;
Stroobants, Sigrid ;
Lister, T. Andrew ;
Hoppe, Richard T. ;
Dreyling, Martin ;
Tobinai, Kensei ;
Vose, Julie M. ;
Connors, Joseph M. ;
Federico, Massimo ;
Diehl, Volker .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (05) :579-586
[8]   Early consolidation by myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission significantly prolongs progression-free survival in mantle-cell lymphoma: results of a prospective randomized trial of the European MCL Network [J].
Dreyling, M ;
Lenz, G ;
Hoster, E ;
Van Hoof, A ;
Gisselbrecht, C ;
Schmits, R ;
Metzner, B ;
Truemper, L ;
Reiser, M ;
Steinhauer, H ;
Boiron, JM ;
Boogaerts, MA ;
Aldaoud, A ;
Silingardi, V ;
Kluin-Nelemans, HC ;
Hasford, J ;
Parwaresch, R ;
Unterhalt, M ;
Hiddemann, W .
BLOOD, 2005, 105 (07) :2677-2684
[9]   Maintenance rituximab after autologous stem cell transplantation in patients with mantle cell lymphoma [J].
Graf, S. A. ;
Stevenson, P. A. ;
Holmberg, L. A. ;
Till, B. G. ;
Press, O. W. ;
Chauncey, T. R. ;
Smith, S. D. ;
Philip, M. ;
Orozco, J. J. ;
Shustov, A. R. ;
Green, D. J. ;
Libby, E. N., III ;
Bensinger, W. I. ;
Pagel, J. M. ;
Maloney, D. G. ;
Zhou, Y. ;
Cassaday, R. D. ;
Gopal, A. K. .
ANNALS OF ONCOLOGY, 2015, 26 (11) :2323-2328
[10]   Autologous stem cell transplantation for non-Hodgkin's lymphoma: comparison of radiation-based and chemotherapy-only preparative regimens [J].
Gutierrez-Delgado, F ;
Maloney, DG ;
Press, OW ;
Golden, J ;
Holmberg, LA ;
Maziarz, RT ;
Hooper, H ;
Buckner, CD ;
Appelbaum, FR ;
Bensinger, WI .
BONE MARROW TRANSPLANTATION, 2001, 28 (05) :455-461