High-dose therapy followed by autologous purged stem cell transplantation and doxorubicin-based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS with final results after a median follow-up of 9 years.

Emmanuel Gyan 1 Charles Foussard 2 Philippe Bertrand 3 Patrick Michenet 4 Steven Le Gouill 5 Christian Berthou 6 Hervé Maisonneuve 7 Vincent Delwail 8 Rémi Gressin 9 Philippe Quittet 10 Jean-Pierre Vilque 11 Bernard Desablens 12 Jérôme Jaubert 13 Jean-François Ramée 14 Nina Arakelyan 15 Antoine Thyss 16 Cécile Moluçon-Chabrot 17 Roselyne Delépine 1 Noël Milpied 18 Philippe Colombat 1 Eric Deconinck 19
1 Service d'hématologie [Tours]
2 Service d'hématologie
3 Département de biostatistiques
4 Service de pathologie
5 Service d'hématologie
6 Service d'hématologie
7 Service d'hématologie
8 Service Hématologie
9 Service d'hématologie
10 Service d'hématologie
11 Centre François Baclesse
12 Laboratoire d'Hématologie
13 Service d'hématologie
14 Service d'hématologie
15 Service d'hématologie
16 Centre Antoine Lacassagne
17 Service d'hématologie
18 Service d'hématologie
19 HOTE GREFFON - Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098)
Abstract : Autologous stem cell transplantation (ASCT) as first-line therapy for follicular lymphoma (FL) remains controversial. The multicenter study randomized 172 patients with untreated FL for either immunochemotherapy or high-dose therapy (HDT) followed by purged ASCT. Conditioning was performed with total body irradiation (TBI) and cyclophosphamide. The 9-year overall survival (OS) was similar in the HDT and conventional chemotherapy groups (76% and 80%, respectively). The 9-year progression-free survival (PFS) was higher in the ASCT than the chemotherapy group (64% vs 39%; P = .004). A PFS plateau was observed in the HDT group after 7 years. On multivariate analysis, OS and PFS were independently affected by the per-formance status score, the number of nodal areas involved, and the treatment group. Secondary malignancies were more frequent in the HDT than in the chemotherapy group (6 secondary myelodysplastic syndrome/acute myeloid leukemia and 6 second solid tumor cancers vs 1 acute myeloid leukemia, P = .01). The occurrence of a PFS plateau suggests that a subgroup of patients might have their FL cured by ASCT. However, the increased rate of secondary malignancies may discourage the use of purged ASCT in combination with TBI as first-line treatment for FL. This trial has been registered with ClinicalTrials.gov under identifier NCT00696735.
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Blood, American Society of Hematology, 2009, 113 (5), pp.995-1001. 〈10.1182/blood-2008-05-160200〉
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http://www.hal.inserm.fr/inserm-00484585
Contributeur : Philippe Saas <>
Soumis le : mardi 18 mai 2010 - 16:07:31
Dernière modification le : mercredi 29 août 2018 - 01:10:20

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UNIV-FCOMTE | UMR645 | FNCLCC | LACASSAGNE

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Emmanuel Gyan, Charles Foussard, Philippe Bertrand, Patrick Michenet, Steven Le Gouill, et al.. High-dose therapy followed by autologous purged stem cell transplantation and doxorubicin-based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS with final results after a median follow-up of 9 years.. Blood, American Society of Hematology, 2009, 113 (5), pp.995-1001. 〈10.1182/blood-2008-05-160200〉. 〈inserm-00484585〉

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