Annals of Oncology 15:283-290, 2004
© 2004 European Society for Medical Oncology
Original Paper |
Intensive chemotherapy and autologous stem-cell transplantation plus rituximab is superior to conventional chemotherapy for newly diagnosed advanced stage mantle-cell lymphoma: a matched pair analysis
Received 12 June 2003; revised 1 October 2003; accepted 29 October 2003Background:
The outcome of 20 patients with newly diagnosed mantle-cell lymphoma (MCL) treated on a prospective trial of autologous stem-cell transplantation (ASCT) and rituximab immunotherapy was compared with the outcome of 40 matched historical control patients treated with standard combination chemotherapy.
Patients and methods:
Control patients with MCL were identified from a lymphoma database, and pairs were matched with patients receiving ASCT–rituximab for stage of disease, gender and age (±5 years). Only patients treated with an anthracycline- or cyclophosphamide–fludarabine-based regimen were included.
Results:
Seventeen of 20 patients who received ASCT–rituximab remain alive in remission at a median of 30 months from diagnosis; one patient relapsed 2 years post-ASCT, and two died at 7 and 11 months post-ASCT without evidence of lymphoma. Of 40 patients treated with conventional chemotherapy, with a median follow-up of 80 months, 33 have relapsed or progressed and 29 have died. Overall (OS) and progression-free (PFS) survival were superior in patients treated with ASCT–rituximab compared with those treated with conventional chemotherapy (PFS at 3 years, 89% versus 29%, P <0.00001; OS at 3 years, 88% versus 65%, P = 0.052).
Conclusions:
This matched-pair analysis suggests that patients with advanced-stage MCL treated with ASCT–rituximab had statistically significantly better PFS and a trend toward better OS than patients treated with conventional chemotherapy. Longer follow-up will determine response duration and the true impact of this treatment strategy on PFS and OS.
1 Advanced Therapeutics Program, Toronto Sunnybrook Regional Cancer Centre, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario; 2 University of British Columbia and the BC Cancer Agency, Vancouver, British Columbia; 3 Princess Margaret Hospital, Toronto, Ontario, Canada
Key words: autologous stem-cell transplantation, mantle-cell lymphoma, matched-pair analysis, rituximab
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