Abstract
This prospective study was designed to determine the safety and efficacy of cyclophosphamide, BCNU, and etoposide (CBV) conditioning and autologous peripheral blood stem cell transplant (PBSCT) in children with relapsed or refractory Hodgkin and non-Hodgkin lymphoma (HL and NHL). Patients achieving complete remission (CR) or partial remission (PR) after 2 to 4 courses of reinduction underwent a granulocyte-colony stimulating factor (G-CSF) mobilized PBSC apheresis with a target collection dose of 5 × 106 CD34+/kg. Those eligible to proceed received autologous PBSCT after CBV (7200 mg/m2, 450-300 mg/m2, 2400 mg/m2). Forty-three of 69 patients (30/39 HL, 13/30 NHL) achieved a CR/PR after reinduction. Thirty-eight patients (28 HL, 10 NHL) underwent PBSCT. All initial 6 patients who received BCNU at 450 mg/m2 experienced grade III or IV pulmonary toxicity compared to none of the subsequent 32 receiving 300 mg/m2 (P<.0001). The probability of overall survival (OS) at 3 years for all patients is 51% and for transplanted patients is 64%. The 3-year event-free survival (EFS) is 38% (45% for HL; 30% NHL). The 3-year EFS in transplanted patients is 66% (65% HL; 70% NHL). Initial duration of remission of ≥12 versus <12 months was associated with a significant increase in OS (3 years OS 70% versus 34%) (P=.003). BCNU at 300 mg/m2 in a CBV regimen prior to PBSCT is well tolerated in relapsed or refractory pediatric lymphoma patients. A short duration (<12 months) of initial remission is associated with a poorer prognosis. Last, a high percentage of patients achieving a CR/PR after reinduction therapy can be salvaged with CBV and autologlous PBSCT.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 249-258 |
| Number of pages | 10 |
| Journal | Biology of Blood and Marrow Transplantation |
| Volume | 17 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2011 |
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Keywords
- Autologous transplant
- CBV
- HL
- Lymphoma
- NHL
- PBSCT
ASJC Scopus subject areas
- Hematology
- Transplantation
Cite this
Autologous Peripheral Blood Stem Cell Transplantation in Children with Refractory or Relapsed Lymphoma : Results of Children's Oncology Group Study A5962. / Harris, Richard E.; Termuhlen, Amanda M.; Smith, Lynette M; Lynch, James; Henry, Michael M.; Perkins, Sherrie L.; Gross, Thomas G.; Warkentin, Phyllis Irene; Vlachos, Adrianna; Harrison, Lauren; Cairo, Mitchell S.
In: Biology of Blood and Marrow Transplantation, Vol. 17, No. 2, 01.02.2011, p. 249-258.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Autologous Peripheral Blood Stem Cell Transplantation in Children with Refractory or Relapsed Lymphoma
T2 - Results of Children's Oncology Group Study A5962
AU - Harris, Richard E.
AU - Termuhlen, Amanda M.
AU - Smith, Lynette M
AU - Lynch, James
AU - Henry, Michael M.
AU - Perkins, Sherrie L.
AU - Gross, Thomas G.
AU - Warkentin, Phyllis Irene
AU - Vlachos, Adrianna
AU - Harrison, Lauren
AU - Cairo, Mitchell S.
PY - 2011/2/1
Y1 - 2011/2/1
N2 - This prospective study was designed to determine the safety and efficacy of cyclophosphamide, BCNU, and etoposide (CBV) conditioning and autologous peripheral blood stem cell transplant (PBSCT) in children with relapsed or refractory Hodgkin and non-Hodgkin lymphoma (HL and NHL). Patients achieving complete remission (CR) or partial remission (PR) after 2 to 4 courses of reinduction underwent a granulocyte-colony stimulating factor (G-CSF) mobilized PBSC apheresis with a target collection dose of 5 × 106 CD34+/kg. Those eligible to proceed received autologous PBSCT after CBV (7200 mg/m2, 450-300 mg/m2, 2400 mg/m2). Forty-three of 69 patients (30/39 HL, 13/30 NHL) achieved a CR/PR after reinduction. Thirty-eight patients (28 HL, 10 NHL) underwent PBSCT. All initial 6 patients who received BCNU at 450 mg/m2 experienced grade III or IV pulmonary toxicity compared to none of the subsequent 32 receiving 300 mg/m2 (P<.0001). The probability of overall survival (OS) at 3 years for all patients is 51% and for transplanted patients is 64%. The 3-year event-free survival (EFS) is 38% (45% for HL; 30% NHL). The 3-year EFS in transplanted patients is 66% (65% HL; 70% NHL). Initial duration of remission of ≥12 versus <12 months was associated with a significant increase in OS (3 years OS 70% versus 34%) (P=.003). BCNU at 300 mg/m2 in a CBV regimen prior to PBSCT is well tolerated in relapsed or refractory pediatric lymphoma patients. A short duration (<12 months) of initial remission is associated with a poorer prognosis. Last, a high percentage of patients achieving a CR/PR after reinduction therapy can be salvaged with CBV and autologlous PBSCT.
AB - This prospective study was designed to determine the safety and efficacy of cyclophosphamide, BCNU, and etoposide (CBV) conditioning and autologous peripheral blood stem cell transplant (PBSCT) in children with relapsed or refractory Hodgkin and non-Hodgkin lymphoma (HL and NHL). Patients achieving complete remission (CR) or partial remission (PR) after 2 to 4 courses of reinduction underwent a granulocyte-colony stimulating factor (G-CSF) mobilized PBSC apheresis with a target collection dose of 5 × 106 CD34+/kg. Those eligible to proceed received autologous PBSCT after CBV (7200 mg/m2, 450-300 mg/m2, 2400 mg/m2). Forty-three of 69 patients (30/39 HL, 13/30 NHL) achieved a CR/PR after reinduction. Thirty-eight patients (28 HL, 10 NHL) underwent PBSCT. All initial 6 patients who received BCNU at 450 mg/m2 experienced grade III or IV pulmonary toxicity compared to none of the subsequent 32 receiving 300 mg/m2 (P<.0001). The probability of overall survival (OS) at 3 years for all patients is 51% and for transplanted patients is 64%. The 3-year event-free survival (EFS) is 38% (45% for HL; 30% NHL). The 3-year EFS in transplanted patients is 66% (65% HL; 70% NHL). Initial duration of remission of ≥12 versus <12 months was associated with a significant increase in OS (3 years OS 70% versus 34%) (P=.003). BCNU at 300 mg/m2 in a CBV regimen prior to PBSCT is well tolerated in relapsed or refractory pediatric lymphoma patients. A short duration (<12 months) of initial remission is associated with a poorer prognosis. Last, a high percentage of patients achieving a CR/PR after reinduction therapy can be salvaged with CBV and autologlous PBSCT.
KW - Autologous transplant
KW - CBV
KW - HL
KW - Lymphoma
KW - NHL
KW - PBSCT
UR - http://www.scopus.com/inward/record.url?scp=79151485721&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79151485721&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2010.07.002
DO - 10.1016/j.bbmt.2010.07.002
M3 - Article
C2 - 20637881
AN - SCOPUS:79151485721
VL - 17
SP - 249
EP - 258
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 2
ER -