Annals of Oncology 11:1585-1590, 2000
© 2000 European Society for Medical Oncology
research-article |
High-dose therapy with autologous stem-cell transplantation (ASCT) after first progression prolonged survival of follicular lymphoma patients included in the prospective GELF 86 protocol
1Service d'Hématologte. H
pital Saint-Louis Paris
2Service d'Hématologie, Institul Paoli Calmettes Marseille
3Service d'Hématologie, Hpital Necker Paris
4Service d'Hématologie clinique, CHU Henri Mondor Créteil
5Service d'Hématologie, Hpital Lyon Sud, Pierre Bénite;
6Service d'Hématologie. Centre Henri Becquerel Rouen
7Service d'Hématologie, Hpital Hötel Dieu Nantes, France
8Service d'Hématologie, Cl. Univ UCL de Mont Godine Yvotr, Belgique
9Service d'Hématologie, CHG Annecy
10Service d'Anatomo-pathologie, Hôpital Necker Paris
11Centre Jean Bernard Le Mans, France
Correspondence to: Dr P. Brice Service d'Hématologie, AP/HP Hpital Saint-Louis 1, avenue Claude Vellefaux 75475 Paris Cedex 10 France E-mail: pauline.brice{at}sls.ap-hop-paris.fr
Background: Among the 566 patients with follicular lymphomas (FL) included in the GELF 86 prospective trials from October 1986 to September 1995, 372 with progressive/relapsing disease were analyzed retrospectively to identify prognostic factors at first relapse.
Patients and methods: For progressive FL, patients received mono- (22%) or polychemotherapy (78%) followed by high-dose therapy (HDT) with ASCT for 83 patients (22%). The median time to progression from initial treatment was 23 months (range 3–102 months) and 24% of documented patients (52 of 217) had histological transformation (HT). Salvage therapy produced an overall response in 64% of patients and the five-year survival from progression was 42%.
Results For patients who underwent HDT with ASCT compared to standard treatment, five-year freedom from second failure was at 42% vs. 16% (P=0.0001) and five-year survival was 58% vs. 38% (P=0.0005), respectively. The benefit of HDT and ASCT remained if we consider only patients less than 65 years (five-year survival at 60% vs. 40% P=0.001). Multivariate analysis of parameters significant according to univariate analysis found that no ASCT at first progression, age at relapse >50 years, progression on-therapy were adversely significant on survival.
Conclusions: HDT with ASCT compared to standard treatment prolonged remission and survival after first progression of FL patients.
autologous stem-cell transplantation, chemotherapy, follicular lymphoma, progression
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