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  • Title: Favorable consolidative effect of high-dose melphalan and total-body irradiation followed by autologous peripheral blood stem cell transplantation after rituximab-containing induction chemotherapy with in vivo purging in relapsed or refractory follicular lymphoma.
    Author: Kato H, Taji H, Ogura M, Kagami Y, Oki Y, Tsujimura A, Fuwa N, Kodaira T, Seto M, Yamamoto K, Morishima Y.
    Journal: Clin Lymphoma Myeloma; 2009 Dec; 9(6):443-8. PubMed ID: 19951884.
    Abstract:
    PURPOSE: In this study, we sought to evaluate the efficacy and toxicity of high-dose therapy followed by autologous peripheral blood stem cell transplantation (autoPBSCT) after rituximab-containing induction chemotherapy with in vivo purging for relapsed or refractory chemosensitive advanced-stage follicular lymphoma (FL). PATIENTS AND METHODS: A rituximab-containing regimen was used as induction chemotherapy and as in vivo purging before PBSC collection. Patients achieving partial or complete response received a regimen consisting of high-dose melphalan and total-body irradiation (TBI). RESULTS: A total of 18 patients with a median age of 45 years were enrolled. The number of previous chemotherapy regimens was 2. The principal nonhematologic toxicities were grade 3 febrile neutropenia and diarrhea. One patient experienced pneumocystis pneumonia, 2 developed interstitial pneumonitis, and 1 experienced agammaglobulinemia, all of whom had complete improvement except for the patient having agammaglobulinemia. Grade 4 toxicities were not observed, and there have been neither treatment-related mortality nor secondary malignancy to date. At a median follow-up of 4.0 years, the 4-year estimated overall and failure-free survival rates were 100% and 88.9%, respectively. CONCLUSION: Consolidation of high-dose melphalan and TBI followed by autoPBSCT with in vivo purging is feasible and effective for relapsed or refractory chemosensitive FL. Longer follow-up is needed to confirm the role and late toxicities.
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