TY - JOUR
T1 - High-dose cyclophosphamide and rituximab without stem cell transplant
T2 - A feasibility study for low grade B-cell, transformed and mantle cell lymphomas
AU - Gladstone, Douglas E.
AU - Bolaños-Meade, Javier
AU - Huff, Carol Ann
AU - Zahurak, Marianna
AU - Flinn, Ian
AU - Borrello, Ivan
AU - Luznik, Leo
AU - Fuchs, Ephraim
AU - Kasamon, Yvette
AU - Matsui, William
AU - Powell, Jonathan
AU - Levitsky, Hyam
AU - Brodsky, Robert A.
AU - Ambinder, Richard
AU - Jones, Richard J.
AU - Swinnen, Lode J.
N1 - Funding Information:
This work was supported by National Institutes of Health grant PO1 CA15396.
PY - 2011/11
Y1 - 2011/11
N2 - Relapse after autologous stem cell transplant for low grade B-cell lymphoma is common secondary to ineffective conditioning and/or tumor autograft contamination. We investigated high-dose cyclophosphamide and rituximab without stem cell rescue as first-line or salvage therapy in lymphomas. After establishing safety, accrual was increased to evaluate event-free survival (EFS). Eighty-one adults received rituximab (375 mg/m 2 days 1, 4, 8, 11, 45, 52), cyclophosphamide (50 mg/kg days 1518), and pegfilgrastim (day 20). Forty-two patients had low grade B-cell lymphoma [grade I/II follicular (69%), transformed lymphoma (17%), other (15%)]: 45% were treated without measurable disease. Thirty-nine patients had mantle cell lymphoma: 82% were treated without measurable disease. All achieved hematopoietic recovery; 46% required brief hospitalizations. The 5-year EFS and overall survival (OS) for patients with low grade B-cell and transformed lymphoma were 40% and 72%, respectively. The 5-year EFS and OS for patients with MCL were 39% and 62%, respectively. This low-toxicity therapeutic approach obviates the need for stem cell products and establishes a platform for future therapies.
AB - Relapse after autologous stem cell transplant for low grade B-cell lymphoma is common secondary to ineffective conditioning and/or tumor autograft contamination. We investigated high-dose cyclophosphamide and rituximab without stem cell rescue as first-line or salvage therapy in lymphomas. After establishing safety, accrual was increased to evaluate event-free survival (EFS). Eighty-one adults received rituximab (375 mg/m 2 days 1, 4, 8, 11, 45, 52), cyclophosphamide (50 mg/kg days 1518), and pegfilgrastim (day 20). Forty-two patients had low grade B-cell lymphoma [grade I/II follicular (69%), transformed lymphoma (17%), other (15%)]: 45% were treated without measurable disease. Thirty-nine patients had mantle cell lymphoma: 82% were treated without measurable disease. All achieved hematopoietic recovery; 46% required brief hospitalizations. The 5-year EFS and overall survival (OS) for patients with low grade B-cell and transformed lymphoma were 40% and 72%, respectively. The 5-year EFS and OS for patients with MCL were 39% and 62%, respectively. This low-toxicity therapeutic approach obviates the need for stem cell products and establishes a platform for future therapies.
KW - Cyclophosphamide
KW - Mantle cell lymphoma
KW - NHL
UR - http://www.scopus.com/inward/record.url?scp=80054977191&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80054977191&partnerID=8YFLogxK
U2 - 10.3109/10428194.2011.594191
DO - 10.3109/10428194.2011.594191
M3 - Article
C2 - 21756035
AN - SCOPUS:80054977191
SN - 1042-8194
VL - 52
SP - 2076
EP - 2081
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 11
ER -