Journal of Experimental Hematology ML AHSCT

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1 598 Journal of Experimental Hematology Article ID * ML AHSCT AHSCT 100 ML AHSCT OS PFS > /L 6. 0 ± 0. 4 d 8. 2 ± 0. 4 d > /L 7. 1 ± 0. 8 d ± 2. 5 d P < OS % 68. 9% % 60. 6% % 56. 2% PFS % 63. 2% % 58. 3% % 55. 3% P > P > R R A Clinical Obse rvation of 100 Patie nts with Malignant Lymphoma Treating with Different Preconditioning Regimens Followed by Autologous He matopoie tic Ste m Ce ll Transplantation SHAO Lan-Lan 1 2 XIAO Xiu-Bin 2 ZHONG Kai-Li 2 LU Yun 2 CHEN Xi-Lin 2 DA Yong 2 LIU Jing 2 ZHAO Shi-Hua 2 MA Yi 2 YANG Qiu-Shi 2 SU Hang 2 ZHANG Wei-Jing 2* 1 Postgraduate Medical School of Chinese People Liberation ArmyBeijing China 2 Department of LymphomaAffiliated Hospital 307Academy of Military Medical SciencesBeijing China * Corresponding Author ZHANG Wei-JingSenior Physician. Tel zhangwj3072@ 163. com Abstract This study was designed to compare the curative effectprognosis and safety of different preconditioning regimens for patients who received autologous hematopoietic stem cell transplantation AHSCT for malignant lymphoma ML. The clinical data of 100 ML patients Sep 1992 to Aug 2010 in 307 Hospital were retrospectively analyzedand were divided into two groups by different preconditioning regimens the high-dose chemotherapy preconditioning group and high-dose chemotherapy /radiotherapy preconditioning group. The overall survival OS rateprogress free survival PFS rate and adverse effect were analyzed. The results showed that until Feb 2011 the median follow-up was months. All patients were engrafted and their hematopoiesis was reconstituted. The median time of WBC recovery up to > /L in high-dose chemotherapy preconditioning group and high-dose chemotherapy / radiotherapy preconditioning group were 6. 0 ± 0. 4 d and 8. 2 ± 0. 4 platelet up to > /L in two groups were 7. 1 ± 0. 8 d and ± 2. 5 d P < The 3-year OS rate of the two groups were 67. 3% and 68. 9%. 5-year OS rates of two groups were 62. 8% and 60. 6% 10-year OS rates of two groups were 57. 6% and 56. 2% respectively 3-year PFS of two group were 63. 6% and 63. 2% 5-year of two group were 59. 4% and 58. 3% 10-year of two group were 50. 8% and 55. 3% respectively P > Meanwhile the incidence of fever infectionbleedingsecondary cancer between two groups was not significant different P > It is concluded that the hematopoietic reconstitution of high-dose chemotherapy /radiotherapy preconditioning group is later than that of high-dose chemotherapy preconditioning group. However there is no significant difference in curative effect and prognosis between the two groups. Key words malignant lymphoma preconditioning regimen autologous hematopoietic stem cell transplantation J Exp Hematol * zhangwj3072@ 163. com

2 Table 1. Clinical data of 100 patients with malignant lymphoma Preconditioning regimen 307 High-dose High-dose Clinical date P-value 100 chemotherapy chemo / radiotherapy n % n % Sex Yes No No Pathology type Ann Arbor Ⅰ - HL Ⅱ37 B NHL Treatment before AHSCT Initial treatment 8 1 Retreatment Status after AHSCT B 1 B CR Burkit 2 B CR2 3 T 2 CR3 T 8 9 PR NK /T 7 SD T 7 T BEAM 300 mg /m d mg / m 12 h d mg / m 2 12 h d mg /m TBI TLI CT MRI PET- 2 d 2CBV 1. 6 g / m 2 d CT 4-2 d mg /m 2 8 d mg / m 2 12 h d TBI TLI CA + Male Female Staging B-symptom Large tumor Yes TBI 7-10 Gy d TLI 6-8 Gy μg /d > /L 8 d g /m d mg /m d

3 600 J Exp Hematol OS PFS PSF OS ± 5. 2 % ± 5. 9 % 5. 5 % ± 5. 8 % ± 7. 5 % OS PFS 3 V Ⅳ % SPSS13. 0 Kaplan-Meier Logrank χ 2 α = ± 6. 3 % PFS ± 100 > /L 6. 7 ± 0. 3 d > /L 6. 1 ± 0. 3 > /L 8. 4 ± 0. 9 P < Table 2. Time of hematopoietic reconstitution in different preconditioning regimen groups Preconditioning regimen High-dose chemotherapy High-dose chemo / radiotherapy WBC > /L Neutrophil Platelet > /L > /L 6. 0 ± ± ± ± ± ± 2. 5 P-value Figure. Kaplan-Merier curves of lymphoma patients after transplantation. P = OS P = PFS % Ⅰ 11% Ⅱ52% Ⅲ12% 18% Ⅰ 3% Ⅱ12% Ⅲ3% 70% 58% 28% 9

4 Table 3. OS and PFS rate between different preconditioning regimen groups Preconditioning regimen n OS rate % 3-year 5-year 10-year PFS rate % 3-year 5-year 10-year High-dose chemotherapy ± ± ± ± ± ± High-dose chemo /radiotherapy ± ± ± ± ± ± 5. 3 P-value Table 4. Side effects in different preconditioning regimen groups Preconditioning regimen Fever n % Infection n % Bacterial Fungous Viral Bleeding n % High-dose chemotherapy High-dose chemo /radiotherapy P-value Preconditioning regimen Gastrointestinal n % Catarrh n % Death related to preconditioning regimen n % Secondary tumor n % High-dose chemotherapy High-dose chemo /radiotherapy P-value P = OS 52% 32% P = Lee NK /T 5% 7% 5 OS 91% Ⅰ 87. 3% 67. 8% P = 24% Ⅱ48% Ⅲ12% Ⅳ7% % 2% OS PFS 4 30 d 4% PFS OS 67. 6% 62. 4% % PFS 63. 3% 58. 7% % Haioun Montoto OS 64% 49% P = PFS 44% 31% 27% 04 PFS 55% 39% P = Philip TBI P < Emmanouilides PFS 46% 12% TBI 4 OS

5 602 J Exp Hematol % 59% P = TBI P < Wei 8 73 TBI BEAM 5 OS 53. 9% 63. 8% P = % 50. 7% P = TBI BEAM % % P > TBI BEAM OS PFS P > Transplant Emmanouilides CWolf CScott Set al. Localized radiation increases morbidity and mortality after TBI-containing autologous stem cell transplantation in patients with lymphoma. Bone Marrow Trans- OS PFS 1365 Krishnan Z-BEAM study. Leukemia TBI 4 OS 81% 52. 7% P = PFS 59. 6% 42% P = TBI Evens 11 plantation stem cell transplantation for non-hodgkin' s lymphoma. 5 OS Oncology Biol PFS 48% 44% 5 56 OS PFS 61% 63% OS PFS 27% 6% P < for Poor-Risk Diffuse Large Cell Lymphoma. Transplant OS PFS 1 Haioun CLepage EGisselbrecht C et al. Survival benefit of highdose therapy in poor-risk aggressive non-hodgkin's lymphoma Final analysis of the prospective LNH 87-2 protocol- A groupe d'etude des lymphomes de l'adulte study. J Clin Oncol Philip TGuglielmi CHagenbeek Aet al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapsed of chemotherapy-sensitive non-hodgkin's lymphoma. J N Engl Med Lee JPark MJKim Ket al. Autologous Hematopoietic Stem Cell Transplantation in Extranodal Natural Killer /T Cell Lymphoma A MultinationalMulticenterMatched Controlled Study. Biol Blood Marrow Transplant Suzuki RSuzumiya JNakamura Set al. Hematopoietic stem cell transplantation for natural killer-cell lineage neoplasms. Bone Marrow Josting ASieniawski MGlossmann JP et al. High-dose sequential chemotherapy followed by autologous stem cell transplantation in relapsed and refractory aggressive non-hodgkin's lymphoma results of a multicenter phase Ⅱstudy. Ann Oncol Montoto SRohatiner AZSSureda Aet al. Long-term follow-up of high-dose treatment with autologous haematopoietic progenitor cell support in 693 patients with follicular lymphoma an EBMT registry 8 Liu HWSeftel MDRubinger Met al. Total body irradiation compared with beam long-term outcomes of peripheral blood autologous Radiation Krishnan ANademanee AThomas SHet al. Matched-Cohort Analysis of Autologous Hematopoietic Cell Transplantation with Radioimmunotherapy versus Total Body Irradiation-Based Conditioning Biol Blood Marrow 11 Evens AMAltman JKMittal BBet al. Phase I /II trial of total lymphoid irradiation and high-dose chemotherapy with autologous stem-cell transplantation for relapsed and refractory Hodgkin' s lymphoma. Annals Oncology