Skip Navigation


Annals of Oncology Advance Access originally published online on August 3, 2006
Annals of Oncology 2006 17(10):1546-1552; doi:10.1093/annonc/mdl153
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
17/10/1546    most recent
mdl153v1
Right arrow E-letters: Submit a response
Right arrow E-letters: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (7)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Betticher, D.
Right arrow Articles by Linch, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Betticher, D.
Right arrow Articles by Linch, D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2006 European Society for Medical Oncology

hematologic malignancies

Sequential high dose chemotherapy as initial treatment for aggressive sub-types of Non-Hodgkin Lymphoma: results of the international randomized phase III trial (MISTRAL)

DC Betticher1,*, G Martinelli2, JA Radford3, M Kaufmann4, MJS Dyer3, U Kaiser4, WE Aulitzky4, J Beck4, A von Rohr1, T Kovascovics1, SB Cogliatti1, S Cina1, R Maibach1, T Cerny1 and DC Linch3

1 SAKK (Swiss Group for Clinical Cancer Research), Bern, Switzerland
2 European Institute of Oncology, Milano, Italy
3 UKCCCR Lymphoma Subcommittee, UK
4 German Lymphoma Study Group, Germany

*Correspondence to: Dr D. Betticher, Clinic of Med. Oncology, Hospital of Fribourg, 1700 Fribourg, Switzerland. E-mail: betticherd{at}hopcantfr.ch

Introduction: Sequential high dose (SHiDo) chemotherapy with stem cell support has been shown to prolong the event-free survival in patients with diffuse large B-cell lymphoma.

Methods: To confirm this result in a multicenter trial, we randomized patients with aggressive NHL, to receive either eight cycles of CHOP or SHiDo. The primary endpoint was overall survival.

Results: 129 evaluable patients were randomized to receive either CHOP or SHiDo: median age, 48 years; 62% male; stage III+IV: 73%; age adjusted International Prognostic Index 1/2/3: 21%/52%/27%. Toxicity grades 3+4 were more pronounced in the SHiDo-arm with 13% versus 3% of patients with fever; 34% versus 13% with infections; 13% versus 2% with esophagitis/dysphagia/gastric ulcer. The remission rates were similar in SHiDo and CHOP arms with 34%/37% complete remissions and 31%/31% partial remissions, respectively. After a median observation time of 48 months, there was no difference in overall survival at 3 years, with 46% for SHiDo and 53% for CHOP (P = 0.48).

Conclusion: In this multicenter trial, early intensification with SHiDo did not confer any survival benefit in previously untreated patients with aggressive NHL and was associated with a higher incidence of grades 3/4 toxicity.

Key words: aggressive lymphoma, autologus bone marrow transplantation, diffuse large cell lymphoma, sequential high dose chemotherapy


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 JCOHome page
C. Tarella, M. Zanni, M. Magni, F. Benedetti, C. Patti, T. Barbui, A. Pileri, M. Boccadoro, F. Ciceri, A. Gallamini, et al.
Rituximab Improves the Efficacy of High-Dose Chemotherapy With Autograft for High-Risk Follicular and Diffuse Large B-Cell Lymphoma: A Multicenter Gruppo Italiano Terapie Innnovative nei Linfomi Survey
J. Clin. Oncol., July 1, 2008; 26(19): 3166 - 3175.
[Abstract] [Full Text] [PDF]

Home page
 haematolHome page
N. Schmitz, P. Dreger, B. Glass, and A. Sureda
Allogeneic transplantation in lymphoma: current status
Haematologica, November 1, 2007; 92(11): 1533 - 1548.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
O. Weingart, F. A. Rehan, H. Schulz, F. Naumann, I. Knauel, C. B. J. Bohlius, and A. Engert
Sixth Biannual Report of the Cochrane Haematological Malignancies Group Focus on Non-Hodgkin Lymphoma
J Natl Cancer Inst, September 5, 2007; 99(17): E1 - E1.
[Full Text] [PDF]

E-letters:

Read all E-letters

Poor results and patient selection bias
Alessandro M Gianni, et al.
Annals of Oncology, 10 Oct 2006 [Full text]
Reply: Poor results and patient selection bias
Daniel C Betticher, et al.
Annals of Oncology, 13 Oct 2006 [Full text]

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.