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Mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) followed by autologous stem cell transplantation for patients with chemosensitive aggressive non-Hodgkin lymphoma

Authors
 Ji-Won Kim  ;  Hyun Jung Lee  ;  Hyeon Gyu Yi  ;  Byung-Su Kim  ;  Soo-Mee Bang  ;  Jin Seok Kim  ;  Inho Kim  ;  Sung-Soo Yoon  ;  Jong Seok Lee  ;  Chul Soo Kim  ;  Seonyang Park  ;  Byoung Kook Kim 
Citation
 AMERICAN JOURNAL OF HEMATOLOGY, Vol.87(5) : 479-483, 2012 
Journal Title
 AMERICAN JOURNAL OF HEMATOLOGY 
ISSN
 0361-8609 
Issue Date
2012
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Bone Marrow Transplantation ; Chemical and Drug Induced Liver Injury/etiology ; Combined Modality Therapy ; Drug Resistance, Neoplasm ; Female ; Humans ; Kaplan-Meier Estimate ; Kidney Diseases/chemically induced ; Lymphoma, Non-Hodgkin/blood ; Lymphoma, Non-Hodgkin/drug therapy* ; Lymphoma, Non-Hodgkin/mortality ; Lymphoma, Non-Hodgkin/surgery* ; Male ; Middle Aged ; Mucositis/chemically induced ; Neoplasm Invasiveness ; Neutropenia/chemically induced ; Peripheral Blood Stem Cell Transplantation* ; Risk Factors ; Transplantation Conditioning/adverse effects ; Transplantation Conditioning/methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult
Keywords
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Bone Marrow Transplantation ; Chemical and Drug Induced Liver Injury/etiology ; Combined Modality Therapy ; Drug Resistance, Neoplasm ; Female ; Humans ; Kaplan-Meier Estimate ; Kidney Diseases/chemically induced ; Lymphoma, Non-Hodgkin/blood ; Lymphoma, Non-Hodgkin/drug therapy* ; Lymphoma, Non-Hodgkin/mortality ; Lymphoma, Non-Hodgkin/surgery* ; Male ; Middle Aged ; Mucositis/chemically induced ; Neoplasm Invasiveness ; Neutropenia/chemically induced ; Peripheral Blood Stem Cell Transplantation* ; Risk Factors ; Transplantation Conditioning/adverse effects ; Transplantation Conditioning/methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult
Abstract
Patients with chemosensitive aggressive non-Hodgkin lymphoma (NHL) could benefit from high-dose chemotherapy (HDC) followed by autologous stem cell transplantation (auto-SCT). We report clinical outcomes of HDC using a novel regimen consisting of mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) with auto-SCT. A total of 69 patients were consecutively enrolled. Median age was 42 years (range, 20–66 years). Median event-free survival (EFS) was 17.9 months. Median overall survival (OS) has not been reached yet and estimated 2-year OS was 64.2%. Among patients with measurable lesions, response rate was 79.5%. Median time to recovery of neutrophil (>500 mL) and platelet (gt;20,000 mL) was 12.5 and 13.5 days, respectively. Febrile neutropenia developed in 61 patients (88.4%). Grades 3 or 4 hepatic toxicity developed in 7 patients (10.1%), Grades 3 or 4 renal toxicity in 2 patients (2.9%), and Grade 3 or 4 cardiac toxicity in 2 patients (2.9%). Transplant-related mortality (TRM) developed in two patients (2.9%). Multiple prior treatments before transplantation, auxiliary bone marrow harvest for stem cell collection, and high serum lactate dehydrogenase level were related to unfavorable treatment outcomes. In conclusion, NEAM conditioning with auto-SCT demonstrated considerable efficacy with modest toxicity in patients with chemosensitive aggressive NHL.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/ajh.23150/abstract
DOI
22388671
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/22282913/89422
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