Early consolidation by myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission significantly prolongs progression-free survival in mantle-cell lymphoma: results of a prospective randomized trial of the European MCL Network
Early consolidation by myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission significantly prolongs progression-free survival in mantle-cell lymphoma: results of a prospective randomized trial of the European MCL Network
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DOI：
10.1182/blood-2004-10-3883
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发表时间：
2005-04-01
期刊：
影响因子：
20.3
通讯作者：
Hiddemann, W
中科院分区：
文献类型：
--
作者：
Dreyling, M;Lenz, G;Hiddemann, W
Mantle-cell淋巴瘤（MCL）的特点是预后差，中位生存期仅为3 - 4年。为了改善临床结果，欧洲MCL网络发起了一项随机试验，比较首次缓解时巩固与清髓放化疗后自体干细胞移植（ASCT）和α -干扰素维持（IFN α）。65岁或以下的晚期MCL患者在接受环磷酰胺、阿霉素、长春新碱和强的松（CHOP）样诱导治疗达到完全或部分缓解后，被分配到ASCT或IFN α治疗。根据国际预后指数（IPI）， 43%的患者为低危，41%为中低危，11%为中高危，6%为高危。122例患者中有62例进行ASCT， 60例接受干扰素α治疗。ASCT组患者的无进展生存期（PFS）显着延长，中位为39个月，而IFNa组患者的中位为17个月（P = 0.0108）。ASCT后的3年总生存率（OS）为83%，而IFN组为77% （P = 0.18）。通过清髓放化疗和ASCT进行早期巩固是可行的，并可显著延长晚期MCL的PFS。需要更长时间的随访来确定对OS的影响。(c) 2005年由美国血液学会出版。
Mantle-cell lymphoma (MCL) is characterized by poor prognosis with a median survival of only 3 to 4 years. To improve clinical outcome, the European MCL Network initiated a randomized trial comparing consolidation with myeloablative radiochemotherapy followed by autologous stem cell transplantation (ASCT) to alpha-interferon maintenance (IFN alpha) in first remission. Patients 65 years of age or younger with advanced-stage MCL were assigned to ASCT or IFN alpha after achievement of complete or partial remission by a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-like induction therapy. According to the International Prognostic Index (IPI), 43% of patients had a low-risk, 41% a low-intermediate, 11% a high-intermediate, and 6% a high-risk profile. Sixty-two of 122 patients proceeded to ASCT and 60 received IFN alpha. Patients in the ASCT arm experienced a significantly longer progression-free survival (PFS) with a median of 39 months compared with 17 months for patients in the IFNa arm (P =.0108). The 3-year overall survival (OS) was 83% after ASCT versus 77% in the IFN group (P =.18). Early consolidation by myeloablative radiochemotherapy followed by ASCT is feasible and results in a significant prolongation of PFS in advanced-stage MCL. Longer follow-up is needed to determine the effect on OS. (c) 2005 by The American Society of Hematology.