Intensive therapy with peripheral stem cell transplantation in 16 patients with mantle cell lymphoma

Ketterer, Nicolas; Salles, Gilles; Espinouse, Daniel; Dumontet, Charles; Neidhardt-Bérard, Eve-Marie; Moullet, Isabelle; Bouafia, Fadhela; Berger, Françoise; Felman, Pascale; Coiffier, B

doi:10.1023/a:1008278605751

Cited by 57 publications

(29 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among these 19 patients, nine were in continued CR with a median follow-up of almost 3 years. Apart from the report of Ketterer et al, 19 all published series have shown a high complete response rate after transplantation. This result demonstrates the possibility of effecting complete resolutions of the disease with therapeutic intensification.…”

Section: Discussionmentioning

confidence: 90%

“…Very few studies, 13,19,20,22 have confirmed that the diagnosis of MCL was based on up-to-date published criteria of the REAL or WHO classifications. Histopathological review therefore confers a more realistic value on our work in terms of defining the efficacy of therapeutic intensification for mantle cell lymphomas.…”

Section: Discussionmentioning

confidence: 99%

“…5,15,16 Several non-randomized studies of myeloablative chemo-and/or radiotherapy regimens have recently been published with controversial views concerning their impact on progressionfree and overall survivals. 13,[17][18][19][20][21][22][23][24] The objectives of this report were (1) to evaluate, in 24 confirmed cases of MCL, the efficacy of therapeutic intensification on response rate, duration of response, event-free and overall survival; and (2) to discuss the true impact of autologous stem cell transplantation for mantle cell lymphomas based on a review of the literature.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of autologous stem cell transplantation in mantle cell lymphoma: a 3-year follow-up study

Decaudin

Brousse

Brice

et al. 2000

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:This study was designed to evaluate the efficacy of therapeutic intensification with autologous stem cell transplantation (ASCT) for mantle cell lymphomas (MCL) in terms of response rate, duration of response, and event-free and overall survivals. Twenty-four patients with confirmed MCL responding to chemotherapy received a high-dose chemo-radiotherapy regimen followed by ASCT. Transplantation was performed during first-line therapy in nine cases, second-line in 13 cases and third-line in two cases. The source of hematopoietic stem cells was peripheral blood for 19 cases. At the time of ASCT, eight patients were in complete remission (33%). Seventeen of the 24 cases received an intensified regimen with TBI and seven received the BEAM or the BEAC regimen. After transplantation, 19 patients were in CR (79%). Nine of these were alive in continued CR at a median follow-up of 34 months, while seven relapsed at a median of 18 months. One patient died from Pneumocystis carinii interstitial pneumonitis and five patients developed secondary malignancies. With a median follow-up after transplantation of 34 months, the 3-year event-free survival was 55% and the 3-year overall survival was 68%. These results indicate that therapeutic intensification with ASCT might be an effective treatment for mantle cell lymphomas. cycline-based chemotherapy of about 60%, the duration of response is extremely short for most patients and the prognosis remains poor with a median survival of less than 3 years. New approaches are therefore warranted to improve this dismal outcome.Chemotherapeutic agents such as fludarabine 11 and 2-chlorodeoxyadenosine 12 have been tested, with no improvement of survival. Hyper-CVAD and high-dose methotrexate/cytarabine appears to be a promising regimen with a response rate of 93% and 38% complete responses. 13 Immunotherapy using monoclonal anti-CD20 antibody, rituximab, has been associated with a 33% response rate. 14 Similarly, a slight prolongation of the median duration of response with interferon alpha has been reported in a few series, with no impact on overall survival. 5,15,16 Several non-randomized studies of myeloablative chemo-and/or radiotherapy regimens have recently been published with controversial views concerning their impact on progressionfree and overall survivals. 13,[17][18][19][20][21][22][23][24] The objectives of this report were (1) to evaluate, in 24 confirmed cases of MCL, the efficacy of therapeutic intensification on response rate, duration of response, event-free and overall survival; and (2) to discuss the true impact of autologous stem cell transplantation for mantle cell lymphomas based on a review of the literature. Patients and methods Patient populationThirty-four patients undergoing autologous stem cell transplantation (ASCT) between 1994 and 1997 in seven Hematology Departments and diagnosed as having mantle cell lymphoma were included in this study.All slides were reviewed by a hematological pathologist (NB) and the diagnosis of MCL was based on a combination of...

show abstract

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of autologous stem cell transplantation in mantle cell lymphoma: a 3-year follow-up study

Decaudin

Brousse

Brice

et al. 2000

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…The published series are mostly retrospective, and have included patient populations which are heterogeneous with respect to extent and nature of prior therapy, status at the time of SCT, type of high-dose regimen, source of stem cells and ex vivo manipulation of stem cell products. [1][2][3][4][5][6][7][8][9][10][11]40,41 In addition, some retrospective studies have not included central histologic review. Reproducible diagnostic criteria for MCL have only recently been established and the consistency of diagnosis for MCL without modern diagnostic techniques is poor.…”

Section: Results Of High-dose Therapy and Autologous Stem Cell Transpmentioning

confidence: 99%

“…A total of 287 autologous transplants for MCL have been reported to the Autologous Blood and Marrow Transplant Registry of North America (ABMTR) since 1990, 177 of which have been performed since 1998. An increasing number of single institution and registry-based studies of SCT for MCL have been reported over the last 5 years, [1][2][3][4][5][6][7][8][9][10][11] and early reports of allogeneic SCT have also been published recently. [12][13][14][15] The number of cases reported in publications or to registries probably represents only a fraction of the total number of transplant procedures being performed for this disease.…”

mentioning

confidence: 99%

Stem cell transplantation for mantle cell lymphoma: should it ever be used outside clinical trials?

2001

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:The outlook for patients with mantle cell lymphoma is poor. The reported median survival in most published series is only 3 to 4 years, and even the most favorable prognostic groups have median survival rates of only 5 years, with no evidence of cure. The use of autologous and allogeneic stem cell transplantation in this disease has increased dramatically in recent years. Despite encouraging reports from single centers and registries, the impact of stem cell transplantation on the outcome for mantle cell lymphoma is unclear. Optimal first-line regimens for mantle cell lymphoma have yet to be defined, and it is therefore difficult to place the role of first remission transplantation in an appropriate context. Prospective randomized trials have been difficult to design and conduct in the absence of a well-defined 'standard' treatment. The role of stem cell transplantation as a salvage strategy is also unknown, although available data suggest that it does not improve survival in heavily pre-treated patients. In the absence of clear evidence for a survival advantage for patients receiving stem cell transplants for mantle cell lymphoma, entry into clinical trials should be a priority. Bone Marrow Transplantation (2001) 28, 813-820.

show abstract

Mantle cell lymphoma in the Chinese: Clinicopathological features and treatment outcome

et al. 1998

View full text Add to dashboard Cite

We report the clinical, molecular, and immunohistological findings of 20 Chinese patients with mantle cell lymphoma diagnosed over a 10-year period. The disease affected mainly elderly patients (median age, 65.5 years) with a male predominance (M/F, 3/1). Eighty percent presented with advanced stage III/IV disease but only 25% had B symptoms. Eighty-five percent had extranodal disease at presentation. Complete remission (CR) and partial remission (PR) were achieved in 45% and 40% of the patients, respectively. There was no difference in the CR rate for patients treated with anthracycline-containing or nonanthracycline-containing regimens (43% and 50%, P = 0.67). Disease progression or relapse was observed after a median of 26 months in patients who initially responded to treatment. Extranodal relapse occurred in the central nervous system (n = 1), bone marrow (n = 1), pleura (n = 2), orbit (n = 2), and the gastrointestinal tract (n = 3). The median overall survival (OS) was 52 months but there were no long-term survivors. This was not different from the median OS of 53 months of patients with diffuse large cell (DLC) lymphoma treated in the same center over the same period (log rank, P = 0.76). Of the 12 patients who were tested for bcl-1 rearrangement by polymerase chain reaction (PCR), five (42%) were positive for rearrangement in the major translocation cluster (MTC) region. The median OS rates were 45 months and 63 months for PCR positive and negative patients, respectively (P = 0.97). In conclusion, MCL is a disease mainly of the elderly in the Chinese with a male predominance and most had advanced-stage disease and extranodal involvement at presentation. Clinicopathologic features and treatment outcome were similar to Caucasian patients, in that the disease combined the aggressive nature of DLC lymphoma and the incurability of low-grade lymphoma.

show abstract

Intensive therapy with peripheral stem cell transplantation in 16 patients with mantle cell lymphoma

Abstract: In this study we were not able to confirm the hypothetical benefit of high-dose chemotherapy and PBSC transplantation in mantle cell lymphoma, even though this approach may be promising in a subgroup of patient.

Cited by 57 publications

References 13 publications

Efficacy of autologous stem cell transplantation in mantle cell lymphoma: a 3-year follow-up study

Efficacy of autologous stem cell transplantation in mantle cell lymphoma: a 3-year follow-up study

Stem cell transplantation for mantle cell lymphoma: should it ever be used outside clinical trials?

Mantle cell lymphoma in the Chinese: Clinicopathological features and treatment outcome

Contact Info

Product

Resources

About