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- Title
High-dose cyclophosphamide and rituximab without stem cell transplant: a feasibility study for low grade B-cell, transformed and mantle cell lymphomas.
- Authors
Gladstone, Douglas E; Bolaños-Meade, Javier; Huff, Carol Ann; Zahurak, Marianna; Flinn, Ian; Borrello, Ivan; Luznik, Leo; Fuchs, Ephraim; Kasamon, Yvette; Matsui, William; Powell, Jonathan; Levitsky, Hyam; Brodsky, Robert A; Ambinder, Richard; Jones, Richard J; Swinnen, Lode J
- Abstract
Relapse after autologous stem cell transplant for low grade B-cell lymphoma is common secondary to ineffective conditioning and/or tumor autograft contamination. We investigated high-dose cyclophosphamide and rituximab without stem cell rescue as first-line or salvage therapy in lymphomas. After establishing safety, accrual was increased to evaluate event-free survival (EFS). Eighty-one adults received rituximab (375 mg/m(2) days 1, 4, 8, 11, 45, 52), cyclophosphamide (50 mg/kg days 15-18), and pegfilgrastim (day 20). Forty-two patients had low grade B-cell lymphoma [grade I/II follicular (69%), transformed lymphoma (17%), other (15%)]: 45% were treated without measurable disease. Thirty-nine patients had mantle cell lymphoma: 82% were treated without measurable disease. All achieved hematopoietic recovery; 46% required brief hospitalizations. The 5-year EFS and overall survival (OS) for patients with low grade B-cell and transformed lymphoma were 40% and 72%, respectively. The 5-year EFS and OS for patients with MCL were 39% and 62%, respectively. This low-toxicity therapeutic approach obviates the need for stem cell products and establishes a platform for future therapies.
- Publication
Leukemia & lymphoma, 2011, Vol 52, Issue 11, p2076
- ISSN
1029-2403
- Publication type
Journal Article
- DOI
10.3109/10428194.2011.594191