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High-Dose Chemo/ABMT Ups Survival in High-Risk NHL

High-Dose Chemo/ABMT Ups Survival in High-Risk NHL

CRETEIL, France—In a study of patients with high-risk aggressive non-Hodgkin’s 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, Créteil, France.

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 significant difference.

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.

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