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| |  Mantle Cell Lymphoma is Curable With Intensive Immunochemotherapy: Presented at ASH By Sophie Bainbridge ATLANTA, GA -- December 10, 2007 -- A rare, but deadly form of cancer, mantle cell lymphoma, is curable using intensive immunochemotherapy, according to a researcher speaking here at the 49th American Society of Hematology (ASH) Annual Meeting and Exposition. Until now, mantle cell lymphoma (MCL) was thought to be incurable. Patients with the disease have a grim prognosis, with more than half dying within 4 years of their initial diagnosis. However, in a phase 2 study of 160 patients with MCL, six cycles of intensive induction immunochemotherapy -- a combination of high-dose cytarabine, maxi-CHOP chemotherapy, rituximab, and stem cell transplantation -- produced a 5-year event-free survival and overall survival of 63% and 74%, respectively, for all patients enrolled in the trial. Of the 144 responders who completed treatment, 72% were without disease at 5 years, a result unheard of before now, according to study presenter Christian H. Geisler, MD, PhD, Chairman, Nordic Lymphoma Group, and Consultant, Department of Hematology, Rigshospitalet, Copenhagen, Denmark. Dr. Geisler reported the final results of the 2nd Nordic MCL trial after a median of 3 years follow-up from study entry at a press briefing here. The unrandomized trial included untreated patients aged 66 years or less. The majority of patients (84%) had stage IV disease, 128 patients had classical cytology, and the rest had blastoid/pleomorphic cytology. Following six cycles of intensive induction immunochemotherapy with alternating cycles of rituximab, maxi-CHOP (dose-intensified CHOP - day 1: cyclophosphamide 1200 mg/m2, doxorubicin 75 mg/m2, vincristine 2 mg; and days 1-5: prednisone 100 mg), and rituximab plus high-dose cytarabine, patients who responded received BEAM/BEAC chemotherapy -- a combination of carmustine, etoposide, cytarabine, and either cyclophosphamide or melphalan -- with in vivo purged rituximab autologous hematopoietic stem cell support. Most (96%) of the patients responded to the induction therapy, with a complete response in 55% and a partial response in 41%. The 91% of responders who completed treatment had a 72% 5-year response duration, Dr. Geisler said. Six (3.8%) patients died as a result of their treatment. Of 77 patients with available primers, 90% had negative results on polymerase chain reaction (PCR) 2 months after autologous hematopoietic stem cell transplantation. Those patients who remained PCR-negative for more than a year posttransplantation had a significantly longer clinical response duration than patients who did not (P <.0001). The addition of rituximab may have been responsible for these results, Dr. Geisler commented. Compared with the 41 patients of the first Nordic MCL study who received four cycles of maxi-CHOP without rituximab before BEAM or BEAC plus autologous hematopoietic stem cell transplantation, the overall survival, event-free survival, and response duration were highly significantly increased. "These results now allow us to believe that this intensive approach may be curative," he concluded. Both studies were supported by the Danish Cancer Society and The Nordic Cancer Union. Dr. Geisler disclosed that he receives research funding from Roche and Bayer Schering Pharma, honoraria from Bayer-Schering Pharma, and that he acts as a consultant for Bayer Schering Pharma, Fresenius, and Genmab.
[Presentation title: Mantle Cell Lymphoma Can Be Cured by Intensive Immunochemotherapy With In-Vivo Purged Stem-Cell Support; Final Report of the Nordic Lymphoma Group MCL2 Study. Abstract LB1 Late Breaking Session]
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