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Type: Artigo de periódico
Title: Upfront high-dose sequential therapy (HDS) versus VACOP-B with or without HDS in aggressive non-Hodgkin's lymphoma: long-term results by the NHLCSG
Author: Olivieri, A
Santini, G
Patti, C
Chisesi, T
De Souza, C
Rubagotti, A
Aversa, S
Billio, A
Porcellini, A
Candela, M
Centurioni, R
Congiu, AM
Brunori, M
Nati, S
Spriano, M
Vimercati, R
Marino, G
Contu, A
Tedeschi, L
Majolino, I
Crugnola, M
Sertoli, MR
Abstract: Background: There is not univocal concordance for using high-dose sequential therapy (HDS) as first-line treatment for aggressive non-Hodgkin's lymphoma (NHL). We designed this study to evaluate the usefulness of HDS followed by high-dose therapy (HDT) with autologous stem cell transplantation as front-line treatment in different subsets of aggressive NHL. Patients and methods: Among 223 patients aged 15-60 years with aggressive, advanced stage NHL, 106 patients were randomized to VACOP-B (etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin) for 12 weeks (plus HDS/HDT in case of persistent disease) (arm A), and 117 patients to VACOP-B for 8 weeks plus upfront HDS/HDT (arm B). Results: According to the intention-to-treat analysis, the complete response rate was 75% for arm A and 72.6% for arm B. With a median follow-up of 62 months there was no difference in 7-year probability of survival (60% and 57.8%; P = 0.5), disease-free survival (DFS) (62% and 71%; P = 0.2) and progression-free survival (PFS) (44.9% and 40.9%; P = 0.7) between the two arms. Subgroup analyses confirmed that the best results in terms of survival, DFS and PFS were achieved by patients with large B-cell NHL without bone marrow (BM) involvement, independently of the treatment arm. Results were poorer in other categories of patients and poorest in patients with BM involvement. Conclusions: Aggressive NHL patients do not benefit from upfront HDS/HDT.
Subject: autologous stem cell transplantation
high-dose sequential therapy
high-grade NHL
Country: Inglaterra
Editor: Oxford Univ Press
Citation: Annals Of Oncology. Oxford Univ Press, v. 16, n. 12, n. 1941, n. 1948, 2005.
Rights: fechado
Identifier DOI: 10.1093/annonc/mdi399
Date Issue: 2005
Appears in Collections:Unicamp - Artigos e Outros Documentos

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