Universität zu Köln

Koenigsmann, M., Casper, J., Kahl, C., Basara, N., Sayer, H. G., Behre, G., Theurich, S., Christopeit, M., Mohren, M., Reichle, A., Metzner, B., Ganser, A., Stadler, M., Uharek, L., Balleisen, L., Hinke, A., Hinke, R. and Niederwieser, D. (2014). Risk-adapted, treosulfan-based therapy with auto- and allo-SCT for relapsed/refractory aggressive NHL: a prospective phase-II trial. Bone Marrow Transplant., 49 (3). S. 410 - 416. LONDON: NATURE PUBLISHING GROUP. ISSN 1476-5365

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Abstract

Since the outcome of relapsed/refractory aggressive non-Hodgkin's lymphoma (NHL) is highly variable, a risk-adapted treatment approach was evaluated. After two cycles of DHAP, patients received high-dose treosulfan/etoposide/carboplatinum (TEC) and autologous stem cell rescue. After TEC, low-risk patients with late relapse (> 1 year after first CR who achieved CR after DHAP received no further treatment. Patients with late relapse who achieved CR or PR only after TEC underwent a second cycle of TEC. High-risk patients with early relapse/refractory disease received treosulfan/fludarabine followed by allogeneic transplantation. Rituximab was added in patients with B-cell lymphoma (86%). At entry, 36% of all 57 patients had refractory disease, 32% early and 32% late relapse. During DHAP treatment, progression occurred in 32% of patients. Of 33 patients who received TEC, 5 received second TEC and 15 allogeneic transplantation. Main toxicity after TEC was oral mucositis (CTC grades 3 and 4 in 50% and 13%, respectively). In total, 42% patients achieved CR. Median OS was 21.4 months for all patients and 32.6 for those who underwent allogeneic transplantation. International prognostic index (IPI) at study entry was highly discriminative at predicting OS (P < 0.0001). Risk-adapted, treosulfan-based therapy with auto -and allo-SCT is feasible. Long-term survival is possible with allogeneic transplantation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koenigsmann, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Casper, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kahl, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Basara, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sayer, H. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Behre, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Theurich, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Christopeit, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohren, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reichle, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Metzner, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ganser, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stadler, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Uharek, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Balleisen, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hinke, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hinke, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Niederwieser, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-444668
DOI:	10.1038/bmt.2013.199
Journal or Publication Title:	Bone Marrow Transplant.
Volume:	49
Number:	3
Page Range:	S. 410 - 416
Date:	2014
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1476-5365
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; HIGH-DOSE CHEMOTHERAPY; SALVAGE THERAPY; LYMPHOMA; BLOOD; RITUXIMAB; REGIMENS; GRADE; MALIGNANCIES Multiple languages Biophysics; Oncology; Hematology; Immunology; Transplantation Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44466