BEAM chemotherapy followed by autologous stem cell support in lymphoma patients: analysis of efficacy, toxicity and prognostic factors (original) (raw)

Figures (6)

Regimens used for NHL as first-line therapy were: MACOP-B = 31, CHOP = 39, ProMACE-MOPP = 21, LSAsL, = 16, ESAHP = 5. As second or subsequent-line therapies, we used mini-BEAM and/or ESHAP. HD = Hodgkin's disease; NHL = non-Hodgkin's lymphoma; LGL = low-grade; IGL = intermediate- and high-grade large cell; HGL = high-grade small cell; CR = complete remission; PR = partial remission, BM = bone marrow; PBSC = peripheral blood stem cell.

Regimens used for NHL as first-line therapy were: MACOP-B = 31, CHOP = 39, ProMACE-MOPP = 21, LSAsL, = 16, ESAHP = 5. As second or subsequent-line therapies, we used mini-BEAM and/or ESHAP. HD = Hodgkin's disease; NHL = non-Hodgkin's lymphoma; LGL = low-grade; IGL = intermediate- and high-grade large cell; HGL = high-grade small cell; CR = complete remission; PR = partial remission, BM = bone marrow; PBSC = peripheral blood stem cell.

22 Discase response and survival following autologous transplantation in NHL and HD LGL = low-grade lymphoma; IGL = intermediate- and high-grade large cell; HGL = high-grade small cell; CR = complete remission; PR = pa response; SD = stable disease; PD = progressive disease; NE = not evaluable. “P = 0.002 (LGL vs IGL + HGL).

22 Discase response and survival following autologous transplantation in NHL and HD LGL = low-grade lymphoma; IGL = intermediate- and high-grade large cell; HGL = high-grade small cell; CR = complete remission; PR = pa response; SD = stable disease; PD = progressive disease; NE = not evaluable. “P = 0.002 (LGL vs IGL + HGL).

Table 3 Efficacy of transplant according to previous status of the disease CR = complete remission; PR = partial remission; SD = stable disease; PD = progressive disease; NE = not evaluable; » = number of cases.

Table 3 Efficacy of transplant according to previous status of the disease CR = complete remission; PR = partial remission; SD = stable disease; PD = progressive disease; NE = not evaluable; » = number of cases.

Figure 2 Disease-free survival in patients with NHL according to the status of the disease at transplant. Prognostic factors in NHL: The univariate analysis for OS showed that 10 parameters had a significant adverse effect on survival: three of them corresponded to characteristics at diagnosis (histology, performance status and LDH) and another six were associated with either response to treat- ment (more than three regimens before the transplant and refractory disease) or with other adverse prognosis factors at the time of transplant (bulky disease, extranodal disease, high LDH, poor performance status) (Table 4). The final parameter with an adverse influence on OS was response to transplant: only 13% of patients who did not reach CR after the transplant were alive at 3 years compared to 77% of those who did (P < 0.0001). In multivariate analysis only response to the transplant, histology (low vs intermedi- ate and high grade), bulky disease and poor performance status remained independent variables.

Figure 2 Disease-free survival in patients with NHL according to the status of the disease at transplant. Prognostic factors in NHL: The univariate analysis for OS showed that 10 parameters had a significant adverse effect on survival: three of them corresponded to characteristics at diagnosis (histology, performance status and LDH) and another six were associated with either response to treat- ment (more than three regimens before the transplant and refractory disease) or with other adverse prognosis factors at the time of transplant (bulky disease, extranodal disease, high LDH, poor performance status) (Table 4). The final parameter with an adverse influence on OS was response to transplant: only 13% of patients who did not reach CR after the transplant were alive at 3 years compared to 77% of those who did (P < 0.0001). In multivariate analysis only response to the transplant, histology (low vs intermedi- ate and high grade), bulky disease and poor performance status remained independent variables.

Figure 1 Overall survival in patients with non-Hodgkin’s lymphomas (low, intermediate and high grade) and Hodgkin's disease.

Figure 1 Overall survival in patients with non-Hodgkin’s lymphomas (low, intermediate and high grade) and Hodgkin's disease.

4 Univariate and multivariate analysis of overall survival in NHL patients groups,”**°! results in refractory patients are very poor: only 8% of our patients were alive at 225 days and none survived at 3 years. ical techniques (data not shown). Although randomiz studies and longer follow-up should confirm the efficacy the transplant in this set of patients in terms of over. survival, there are other reasons for considering ear transplant in young LGL patients with poor prognosis: o reason is to avoid repetitive chemotherapy which cou increase the risk of MDS or secondary tumors; anoth important reason is the excellent quality of life for patier transplanted in CR.

4 Univariate and multivariate analysis of overall survival in NHL patients groups,”**°! results in refractory patients are very poor: only 8% of our patients were alive at 225 days and none survived at 3 years. ical techniques (data not shown). Although randomiz studies and longer follow-up should confirm the efficacy the transplant in this set of patients in terms of over. survival, there are other reasons for considering ear transplant in young LGL patients with poor prognosis: o reason is to avoid repetitive chemotherapy which cou increase the risk of MDS or secondary tumors; anoth important reason is the excellent quality of life for patier transplanted in CR.

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