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Multicenter analysis of treatment outcomes in adult patients with lymphoblastic lymphoma who received hyper-CVAD induction followed by hematopoietic stem cell transplantation

Authors
 Seong Hyun Jeong  ;  Joon Ho Moon  ;  Jin Seok Kim  ;  Deok-Hwan Yang  ;  Yong Park  ;  Seok Goo Cho  ;  Jae-Yong Kwak  ;  Hyeon Seok Eom  ;  Jong Ho Won  ;  Jun Shik Hong  ;  Sung Yong Oh  ;  Ho Sup Lee  ;  Seok Jin Kim 
Citation
 ANNALS OF HEMATOLOGY, Vol.94(4) : 617-625, 2015 
Journal Title
 ANNALS OF HEMATOLOGY 
ISSN
 0939-5555 
Issue Date
2015
MeSH
Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Combined Modality Therapy ; Cyclophosphamide/therapeutic use ; Dexamethasone/therapeutic use ; Doxorubicin/therapeutic use ; Female ; Hematopoietic Stem Cell Transplantation* ; Humans ; Induction Chemotherapy/methods* ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy* ; Retrospective Studies ; Survival Analysis ; Treatment Outcome ; Vincristine/therapeutic use ; Young Adult
Keywords
Lymphoblastic lymphoma ; Hyper-CVAD ; Stem cell transplantation
Abstract
The hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen has been widely used for lymphoblastic lymphoma (LBL) as a primary treatment. However, there is few data about its treatment outcome in Asian patients. Thus, we conducted this study to evaluate the efficacy of hyper-CVAD induction and stem cell transplantation (SCT) consolidation in LBL patients. The treatment responses of 49 patients treated with the hyper-CVAD regimen were retrospectively analyzed in 13 institutions. Given 24 patients who responded to hyper-CVAD underwent consolidation treatment with SCT, overall survival (OS) and progression-free survival (PFS) of patients who received SCT were compared with patients who did not. The overall response rate was 79 %: 73 % (36/49) complete responses, 6 % (3/49) partial responses, and 4 % (2/49) induction deaths. The major limitation for the delivery of the planned hyper-CVAD cycles was hematological toxicity. Among 39 responders, 24 patients underwent autologous (n = 16) and allogeneic SCT (n = 8) consolidation. Their 3-year OS and PFS rates were 76 and 78 %, respectively, and there was no difference in survival outcomes between autologous and allogeneic SCT. However, 15 patients without SCT consolidation showed poorer PFS even though they all achieved complete response. Thus, only seven patients maintained their response at the time of analysis. In conclusion, the hyper-CVAD regimen is effective for remission induction in LBL, and SCT consolidation after hyper-CVAD induction produced better clinical outcomes than did continuation of hyper-CVAD.
Full Text
http://link.springer.com/article/10.1007%2Fs00277-014-2258-y
DOI
10.1007/s00277-014-2258-y
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139688
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