TY - JOUR
T1 - Is total body irradiation a necessary component of preparative therapy for autologous transplantation in non-Hodgkin's lymphoma
AU - Stein, R. S.
AU - Greer, J. P.
AU - Goodman, S.
AU - Brandt, S. J.
AU - Morgan, D. S.
AU - Macon, W. R.
AU - McCurley, T. L.
AU - Wolff, S. N.
PY - 2001
Y1 - 2001
N2 - Between September 1986 and June 1998, 157 patients with low grade, intermediate grade, or high grade lymphoma underwent autologous transplantation at a single institution. Two preparative regimens were used: cyclophosphamide, etoposide, total body irradiation (CY-VP-TBI) (N=110) and cyclophosphamide, BCNU, etoposide (CBV) (N=47). The two groups were not significantly different with respect to source of stem cells, gender, stage at presentation, incidence of prior bone marrow involvement, sensitivity to salvage therapy, or histologic grade of lymphoma. The CBV group was significantly older, 49% of patients over age 50, as compared to 26% of patients over age 50 for the CY-VP-TBI group. Response rates and the incidence of fatal toxicity were similar for the two groups. Five year actuarial survival was 31% ±9% for CBV and 38%± 5% for CY-VP-TBI, p=.85. In a multivariate analysis, in which preparative regimen, age, histologic grade of lymphoma, and sensitivity to salvage therapy were the independent variables, TBI was not significantly associated with survival, and the direction of the trend was for TBI to be less effective than CBV. TBI does not appear to be an essential component of preparative therapy for autologous transplantation in patients with lymphoma.
AB - Between September 1986 and June 1998, 157 patients with low grade, intermediate grade, or high grade lymphoma underwent autologous transplantation at a single institution. Two preparative regimens were used: cyclophosphamide, etoposide, total body irradiation (CY-VP-TBI) (N=110) and cyclophosphamide, BCNU, etoposide (CBV) (N=47). The two groups were not significantly different with respect to source of stem cells, gender, stage at presentation, incidence of prior bone marrow involvement, sensitivity to salvage therapy, or histologic grade of lymphoma. The CBV group was significantly older, 49% of patients over age 50, as compared to 26% of patients over age 50 for the CY-VP-TBI group. Response rates and the incidence of fatal toxicity were similar for the two groups. Five year actuarial survival was 31% ±9% for CBV and 38%± 5% for CY-VP-TBI, p=.85. In a multivariate analysis, in which preparative regimen, age, histologic grade of lymphoma, and sensitivity to salvage therapy were the independent variables, TBI was not significantly associated with survival, and the direction of the trend was for TBI to be less effective than CBV. TBI does not appear to be an essential component of preparative therapy for autologous transplantation in patients with lymphoma.
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U2 - 10.3109/10428190109057958
DO - 10.3109/10428190109057958
M3 - Article
C2 - 11342361
AN - SCOPUS:0035072522
SN - 1042-8194
VL - 41
SP - 97
EP - 103
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 1-2
ER -