NEW ORLEANSThe chemotherapy regimen HCVAD followed by stem cell
transplantation yields high response and survival rates for patients
with aggressive mantle cell lymphoma, Issa Khouri, MD, of the M.D.
Anderson Cancer Center, reported at the 41st annual meeting of the
American Society of Hematology (ASH).
The study involved 37 patients with poor-risk mantle cell lymphoma
who had not been previously treated.
HCVAD was administered according to the following schedule:
Cyclophosphamide at 300 mg/m² every 12 hours for six doses with
Vincristine 2 mg administered intravenously 12 hours after the last
cyclophosphamide dose and again on day 11.
Dexamethasone 40 mg/d on days 1 to 4 and 11 to 14.
Adriamycin 50 mg/m² continuous infusion on days 4 and 5.
After a cycle of HCVAD, each patient then received a cycle of
methotrexate at 1 g/m² over 24 hours on day 1 with leucovorin
rescue and cytarabine at 3 g/m² every 12 hours, for a total of
four doses on days 2 and 3. The patients then went through one more
round of HCVAD followed by methotrexate and cytarabine.
Of the 37 patients, seven did not undergo transplant, five because of
patient preference or insurance difficulties, one because of disease
progression, and one who died during the HCVAD treatment.
Of those who received a stem cell transplant, 4 patients had an
allogeneic transplant, and 26 an autologous transplant. The type of
transplant depended on the patients age and whether a suitable
related donor was available. One patient died as a result of stem
Eighteen patients (49%) had a partial remission, and 17 (46%) a
complete remission. All patients who had a stem cell transplant and
survived had a complete remission, although 3 patients relapsed after
a median follow-up of 34 months. The researchers project that 4-year
survival will be 90%.