CRETEIL, FranceIn a study of patients with high-risk aggressive
non-Hodgkins lymphoma (NHL), those receiving high-dose
chemotherapy and autologous bone marrow transplant (ABMT) after
induction therapy lived longer than those receiving sequential
chemotherapy, said Corinne Haioun, MD, of Hospital Henri Mondor,
Dr. Haioun, speaking at the 41st Annual Meeting of the American
Society of Hematology (New Orleans), reported on the final results of
a long-term study of 916 patients who were newly diagnosed with
aggressive NHL when they enrolled. All patients first went through an
induction phase, and 614 patients achieved complete remission.
Of the 614 patients in complete remission, 514 were randomized into
one of two consolidation therapy groups:
Thirteen weeks of outpatient sequential chemotherapy
consisting of high-dose methotrexate, ifosfamide (Ifex), etoposide,
asparaginase (Elspar), and cytarabine.
High-dose methotrexate and CBV (cyclophosphamide 6 g/m²,
carmustine 300 mg/m² , and etoposide 1 g/m²) followed by ABMT.
There were no differences in disease-free survival between the two
treatment groups when the researchers looked at all the subjects
together, Dr. Haioun said. In evaluating the high-risk patients
separately, however, the researchers did find a difference in survival.
Among the 236 patients with two or three risk factors (an
International Prognostic Index of 2 or 3), the 8-year disease-free
survival rate was 55% for those who underwent high-dose therapy with
ABMT and only 39% for those who had sequential chemotherapy, a
Overall 8-year survival, too, was significantly better for those
receiving ABMT (64%) than for those on sequential chemotherapy (49%).
In our high-risk population . . . the CBV therapy was superior
to sequential chemotherapy, Dr. Haioun said. She concluded that
high-dose therapy/ABMT should be offered to high-risk NHL patients
who go into complete remission after induction treatment.