ORLANDOHigh-dose therapy with stem cell support improves event-free
survival in patients with mantle cell lymphoma when performed in first
remission, according to results of a European Intergroup study presented at the
41st Annual Meeting of the American Society of Hematology (abstract 3572).
"Mantle cell lymphoma is one of the most challenging of the lymphomas.
It exhibits an indolent histology, yet an aggressive clinical course,"
said Martin Dreyling, MD, University Hospital, Munich. With its short survival
of 2½ to 3 years, mantle cell lymphoma resembles an aggressive NHL, but it is
not curable. Many chemotherapy regimens, including interferon maintenance, can
induce transient responses.
‘Dismal Clinical Course’
"The disease has a dismal clinical course uninfluenced by conventional
chemotherapy with single or combined agents. New therapy options are urgently
needed," he said. Recently, high-dose chemotherapy with stem cell rescue
and total-body irradiation has emerged as a viable treatment option (Ketterer:
Ann Oncol 8:701, 1997).
Dr. Dreyling and his colleagues from the European Mantle Cell Lymphoma
Intergroup (coordinator: Professor Wolfgang Hiddemann) reported preliminary
results of a prospective randomized trial to answer the key question of whether
high-dose therapy with transplant is better than conventional interferon
maintenance therapy in patients with mantle cell lymphoma who obtained a
complete or partial remission after initial cytoreductive chemotherapy.
Dr. Dreyling noted that mantle cell lymphoma is much less sensitive to
high-dose chemotherapy "if it is already relapsed. Thus, we decided to
evaluate the value of high-dose chemotherapy in first-line therapy."
Centers in Belgium, France, Germany, Great Britain, Italy, the Netherlands,
Spain, and Switzerland enrolled 180 patients; 147 patients had confirmed mantle
cell lymphoma histology, and 130 were evaluable for response. Median patient
age was 53 years.