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Annals of Oncology 12:513-517, 2001
© 2001 European Society for Medical Oncology

research-article

Clinical outcome after front-line intensive sequential chemotherapy (ISC) in patients with aggressive non-Hodgkin's lymphoma and high-risk international prognostic index (IPI 3): Final analysis of survival in two consecutive ISC trials

R. Bouabdallah, A. M. Stoppa, D. Coso, V. J. Bardou, D. Blaise, C. Chabannon, J. A. Gastaut and D. Maraninchi

Department of Hematology, Institut Paoh-Calmettes, Regional Cancer Center-Université de la Médierranée Marseille, France

Correspondence to: R Bouabdallah, MD, Department of Hematology, Institut J Paoli-I Calmettes, 232, Boulevard Sainte-Marguerite, 13273 Marseille Cedex 09, France, E-mail hematol{at}marseille.fnelec.fr

Background Aggressive non-Hodgkin's lymphomas (NHL) in patients under the age of 60 have a very poor prognosis when the international prognostic index (IPI) is high, with an age-adjusted (Aa)-IPI score at 3 In such patients, conventional chemotherapy results in a low complete response (CR) rate of 46%, a five-year survival and disease-free survival (DFS) of 32% and 58%, respectively For this report we have analyzed whether front-line high-dose chemotherapy could influence the outcome of this group of patients

Patients and methods From 1992 onwards we conducted two pilot clinical trials of intensive sequential chemotherapy (ISC) with growth factors and blood stem cell support as initial treatment in 62 poor-risk patients with aggressive NHL Of these patients, 33 were considered to be a high-risk group based on the Aa-IPI

Results The median age was 42 years (range 21–60). The treatment was completed in 88% of patients, 86% receiving greater than 75% or more of the projected dose-intensity Twenty patients (61%) achieved a CR At a median follow-up of 48 months (range 26–86), the estimated five-year survival and DFS was 51% (95% confidence interval (CI) 34%-68%) and 70% (95% Cl 50%–90%), respectively

Conclusion These results suggest that primary treatment using high-dose therapy supported by both growth factors and peripheral blood stem cells can cure up to 50% of high-risk patients with malignant lymphomas

aggressive lymphomas, high-dose therapy, survival


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