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High-dose fractionated total-body irradiation, etoposide, and cyclophosphamide followed by autologous stem-cell support in patients with malignant lymphoma.

Publication ,  Journal Article
Weaver, CH; Petersen, FB; Appelbaum, FR; Bensinger, WI; Press, O; Martin, P; Sandmaier, B; Deeg, HJ; Hansen, JA; Brunvand, M
Published in: J Clin Oncol
December 1994

PURPOSE: To evaluate a high-dose treatment regimen of fractionated total-body irradiation (TBI), etoposide, and cyclophosphamide (Cy) followed by autologous stem-cell transplantation (ASCT) in patients with malignant lymphoma. PATIENTS AND METHODS: Fifty-three patients with non-Hodgkin's lymphoma (NHL; n = 43) or Hodgkin's disease (HD; n = 10) received 12.0 Gy of fractionated TBI, etoposide 60 mg/kg, and Cy 100 mg/kg followed by infusion of autologous hematopoietic stem cells. RESULTS: Thirty-one of 53 patients are alive a median of 643 (range, 177 to 1,144) days after transplant. The 2 year Kaplan-Meier (K-M) estimates of survival, event-free survival (EFS), and relapse for all 53 patients were 54%, 45%, and 43%, respectively. Sixteen of 24 patients with less advanced disease and 10 of 29 patients with more advanced disease survive free of disease for K-M estimates of EFS of 61% and 31%, respectively (P = .006). The K-M estimates of relapse were 34% for patients with less advanced disease and 53% (P = .05) for patients with more advanced disease. The K-M estimates of dying from causes other than relapse were 8% in patients with less versus 25% in patients with more advanced disease (P = .09). CONCLUSION: These data indicate that approximately 60% of patients transplanted early after failure of initial therapy for malignant lymphoma are projected to be disease-free more than 2 years after treatment with fractionated TBI, etoposide, and Cy and infusion of autologous hematopoietic stem cells. The transplant-related mortality rate is low and relapse is the main cause of treatment failure in patients with less advanced disease. For patients with more advanced disease, the K-M estimates of both transplant-related deaths (25%) and relapse (53%) remain major problems.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

December 1994

Volume

12

Issue

12

Start / End Page

2559 / 2566

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Treatment Outcome
  • Transplantation, Autologous
  • Survival Rate
  • Radiotherapy Dosage
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lymphoma, Non-Hodgkin
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Weaver, C. H., Petersen, F. B., Appelbaum, F. R., Bensinger, W. I., Press, O., Martin, P., … Brunvand, M. (1994). High-dose fractionated total-body irradiation, etoposide, and cyclophosphamide followed by autologous stem-cell support in patients with malignant lymphoma. J Clin Oncol, 12(12), 2559–2566. https://doi.org/10.1200/JCO.1994.12.12.2559
Weaver, C. H., F. B. Petersen, F. R. Appelbaum, W. I. Bensinger, O. Press, P. Martin, B. Sandmaier, H. J. Deeg, J. A. Hansen, and M. Brunvand. “High-dose fractionated total-body irradiation, etoposide, and cyclophosphamide followed by autologous stem-cell support in patients with malignant lymphoma.J Clin Oncol 12, no. 12 (December 1994): 2559–66. https://doi.org/10.1200/JCO.1994.12.12.2559.
Weaver CH, Petersen FB, Appelbaum FR, Bensinger WI, Press O, Martin P, et al. High-dose fractionated total-body irradiation, etoposide, and cyclophosphamide followed by autologous stem-cell support in patients with malignant lymphoma. J Clin Oncol. 1994 Dec;12(12):2559–66.
Weaver, C. H., et al. “High-dose fractionated total-body irradiation, etoposide, and cyclophosphamide followed by autologous stem-cell support in patients with malignant lymphoma.J Clin Oncol, vol. 12, no. 12, Dec. 1994, pp. 2559–66. Pubmed, doi:10.1200/JCO.1994.12.12.2559.
Weaver CH, Petersen FB, Appelbaum FR, Bensinger WI, Press O, Martin P, Sandmaier B, Deeg HJ, Hansen JA, Brunvand M. High-dose fractionated total-body irradiation, etoposide, and cyclophosphamide followed by autologous stem-cell support in patients with malignant lymphoma. J Clin Oncol. 1994 Dec;12(12):2559–2566.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

December 1994

Volume

12

Issue

12

Start / End Page

2559 / 2566

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Treatment Outcome
  • Transplantation, Autologous
  • Survival Rate
  • Radiotherapy Dosage
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lymphoma, Non-Hodgkin
  • Humans