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Brazilian experience using high dose sequential chemotherapy followed by autologous hematopoietic stem cell transplantation for malignant lymphomas
- Source :
- Revista Brasileira de Hematologia e Hemoterapia v.33 n.6 2011, Revista brasileira de hematologia e hemoterapia, Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular (ABHHTC), instacron:ABHHTC, Revista Brasileira de Hematologia e Hemoterapia, Vol 33, Iss 6, Pp 432-438 (2011), Revista Brasileira de Hematologia e Hemoterapia, Volume: 33, Issue: 6, Pages: 432-438, Published: DEC 2011, Revista Brasileira de Hematologia e Hemoterapia
- Publication Year :
- 2011
- Publisher :
- Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular, 2011.
-
Abstract
- OBJECTIVE: To evaluate the use of high-dose sequential chemotherapy in a Brazilian population. METHODS: High-dose cyclophosphamide followed by autologous hematopoietic stem cell transplantation is an effective and feasible therapy for refractory/relapsed lymphomas; this regimen has never before been evaluated in a Brazilian population. All patients (106 with high-grade non-Hodgkin lymphoma and 77 with Hodgkin's lymphoma) submitted to this treatment between 1998 and 2006 were analyzed. Chemotherapy consisted of the sequential administration of high-dose cyclophosphamide (4 or 7 g/m²) and granulocyte-colony stimulating factor (300 µg/day), followed by peripheral blood progenitor cell harvesting, administration of etoposide (2g/m²) and methotrexate (8 g/m² only for Hodgkin's lymphoma) and autologous hematopoietic stem cell transplantation. RESULTS: At diagnosis, non-Hodgkin lymphoma patients had a median age of 45 (range: 8-65) years old, 78% had diffuse large B-cell lymphoma and 83% had stage III/IV disease. The Hodgkin's lymphoma patients had a median age of 23 (range: 7-68) years old, 64.9% had the nodular sclerosis subtype and 65% had stage III/IV disease. Nine Hodgkin's lymphoma patients (13%) and 10 (9%) non-Hodgkin lymphoma patients had some kind of cardiac toxicity. The overall survival, disease-free survival and progression-free survival in Hodgkin's lymphoma were 29%, 59% and 26%, respectively. In non-Hodgkin lymphoma, these values were 40%, 49% and 31%, respectively. High-dose cyclophosphamide-related mortality was 10% for Hodgkin's lymphoma and 5% for non-Hodgkin lymphoma patients. High-dose cyclophosphamide dosing had no impact on toxicity or survival for both groups. CONCLUSIONS: Despite a greater prevalence of poor prognostic factors, our results are comparable to the literature. The incidence of secondary neoplasias is noteworthy. Our study suggests that this approach is efficient and feasible, regardless of toxicity-related mortality.
- Subjects :
- Oncology
medicine.medical_specialty
Hodgkin disease
Cyclophosphamide
Lymphoma
Hodgkin disease/drug therapy
medicine.medical_treatment
Hematopoietic stem cell transplantation
Cyclophosphamide/administration & dosage
Nodular sclerosis
immune system diseases
Internal medicine
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
medicine
Etoposide
Chemotherapy
lcsh:RC633-647.5
business.industry
lcsh:Diseases of the blood and blood-forming organs
Hematology
Antineoplastic Combined Chemotherapy Protocols/administration & dosage
medicine.disease
Lymphoma, non-Hodgkin
Surgery
Regimen
Transplantation, autologous
Original Article
Methotrexate
business
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Revista Brasileira de Hematologia e Hemoterapia v.33 n.6 2011, Revista brasileira de hematologia e hemoterapia, Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular (ABHHTC), instacron:ABHHTC, Revista Brasileira de Hematologia e Hemoterapia, Vol 33, Iss 6, Pp 432-438 (2011), Revista Brasileira de Hematologia e Hemoterapia, Volume: 33, Issue: 6, Pages: 432-438, Published: DEC 2011, Revista Brasileira de Hematologia e Hemoterapia
- Accession number :
- edsair.doi.dedup.....d81a8e79e4310d8090eee52b81c1c12f