Hyper-CVAD and high-dose methotrexate/cytarabine followed by stem-cell transplantation: an active regimen for aggressive mantle-cell lymphoma.

Khouri, Issa F.; Romaguera, Jorge; Kantarjian, Hagop M.; Palmer, Jeanne; Pugh, William; Körbling, Martin; Hagemeister, Fredrick B.; Samuels, Barry I; Rodriguez, A.; Giralt, Sergío; Younes, Anas; Przepiorka, Donna; Claxton, DF; Cabanillas, Fernando; Champlin, Richard E.

doi:10.1200/jco.1998.16.12.3803

Cited by 325 publications

(191 citation statements)

References 23 publications

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“…9 In this study, 3 year EFS and OS rates were 72% and 92%, respectively, for previously untreated patients, compared with 17% and 25% in those patients who had received prior therapy. Comparison of these patients with 25 historical control patients who had received CHOP-like chemotherapy without proceeding to SCT showed a markedly superior EFS and OS in the transplant group.…”

Section: Adverse Factor Referencementioning

confidence: 92%

“…The published series are mostly retrospective, and have included patient populations which are heterogeneous with respect to extent and nature of prior therapy, status at the time of SCT, type of high-dose regimen, source of stem cells and ex vivo manipulation of stem cell products. [1][2][3][4][5][6][7][8][9][10][11]40,41 In addition, some retrospective studies have not included central histologic review. Reproducible diagnostic criteria for MCL have only recently been established and the consistency of diagnosis for MCL without modern diagnostic techniques is poor.…”

Section: Results Of High-dose Therapy and Autologous Stem Cell Transpmentioning

confidence: 99%

“…A total of 287 autologous transplants for MCL have been reported to the Autologous Blood and Marrow Transplant Registry of North America (ABMTR) since 1990, 177 of which have been performed since 1998. An increasing number of single institution and registry-based studies of SCT for MCL have been reported over the last 5 years, [1][2][3][4][5][6][7][8][9][10][11] and early reports of allogeneic SCT have also been published recently. [12][13][14][15] The number of cases reported in publications or to registries probably represents only a fraction of the total number of transplant procedures being performed for this disease.…”

mentioning

confidence: 99%

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Stem cell transplantation for mantle cell lymphoma: should it ever be used outside clinical trials?

2001

Bone Marrow Transplant

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Summary:The outlook for patients with mantle cell lymphoma is poor. The reported median survival in most published series is only 3 to 4 years, and even the most favorable prognostic groups have median survival rates of only 5 years, with no evidence of cure. The use of autologous and allogeneic stem cell transplantation in this disease has increased dramatically in recent years. Despite encouraging reports from single centers and registries, the impact of stem cell transplantation on the outcome for mantle cell lymphoma is unclear. Optimal first-line regimens for mantle cell lymphoma have yet to be defined, and it is therefore difficult to place the role of first remission transplantation in an appropriate context. Prospective randomized trials have been difficult to design and conduct in the absence of a well-defined 'standard' treatment. The role of stem cell transplantation as a salvage strategy is also unknown, although available data suggest that it does not improve survival in heavily pre-treated patients. In the absence of clear evidence for a survival advantage for patients receiving stem cell transplants for mantle cell lymphoma, entry into clinical trials should be a priority. Bone Marrow Transplantation (2001) 28, 813-820.

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Section: Adverse Factor Referencementioning

confidence: 92%

Section: Results Of High-dose Therapy and Autologous Stem Cell Transpmentioning

confidence: 99%

mentioning

confidence: 99%

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Stem cell transplantation for mantle cell lymphoma: should it ever be used outside clinical trials?

2001

Bone Marrow Transplant

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“…6,[9][10][11] The superior outcome of patients transplanted in CR1 has been a consistent finding in most reported series, and argues for the application of high-dose therapy with autologous HPCT as part of the primary treatment. 5,[12][13][14][15][16] Nevertheless, it remains unclear whether autologous HPCT is actually curative, and the optimal timing of transplantation remains a point of debate.…”

Section: Introductionmentioning

confidence: 99%

“…The addition of rituximab to cytotoxic chemotherapy regimens has improved the response rates, but the impact on longterm survival remains to be demonstrated. 3,4 Aggressive regimens, such as hyper CVAD (cyclophosphamide, vincristine, doxorubicin and dexamethasone) plus rituximab, consistently produce high response rates, [5][6][7][8] and the followup to date appears promising.…”

Section: Introductionmentioning

confidence: 99%

Long-term progression-free survival after early autologous transplantation for mantle-cell lymphoma

Murali

Winton

Waller

et al. 2008

Bone Marrow Transplant

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Autologous hematopoietic progenitor SCT (HPCT) has been studied both as a consolidative and salvage maneuver in mantle-cell lymphoma (MCL), and may improve failurefree survival rates as well as overall survival. We describe 21 patients with MCL who received autologous HPCT at Emory University Hospital as part of the primary treatment strategy. Sixteen patients were in CR1 and five in PR1 at the time of HPCT. The most commonly used induction chemotherapy was the hyper-CVAD (cyclophosphamide, vincristine, doxorubicin and dexamethasone) regimen with or without rituximab. At the last follow-up, 17 patients were in continuous CR, and there were four relapses. There were no transplant-related deaths. With a median follow-up of 54 months from HPCT, 5-year progression-free survival and overall survival are 73% and 76%, respectively. Our retrospective analysis provides the longest follow-up to date for patients with MCL who received an autologous HPCT as part of primary treatment. This lengthy follow-up helps define the natural course of MCL after autologous transplantation.

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Molecular modelling of trimethoprim complexes of human wild-type and mutant dihydrofolate reductases: identification of two subsets of binding residues in the antifolate binding site

Pan

Bowen

Southerland

1999

Biopharm. Drug Dispos.

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Computer‐assisted molecular modelling was used to generate structures for the trimethoprim (TMP):NADPH:dihydrofolate reductase (DHFR) ternary complexes for human wild‐type DHFR and for five DHFR mutants (L22R, L22F, F31S, F31W and Q35P). The mutants correspond to DHFR proteins that have been isolated from tissues exposed to chronic or high dose methotrexate (MTX) and show decreased sensitivity to antifolate inhibition. Analysis of the TMP:DHFR interactions suggest the presence of two subsets of TMP binding residues in the DHFR antifolate binding site. One subset of these residues (GLU30, PHE34, ILE60 and VAL115) are common to each DHFR complex studied and are referred to as core residues. The other TMP binding residues vary among the DHFR complexes studied and are referred to as noncore residues. The core residues exhibit a greater number of TMP contacts/residue and form more stable TMP interactions than noncore residues. Additionally, the core and noncore residues make contact with different regions of the TMP structure. Information presented here provides additional insight into the design of new agents for the improved inhibition of wild‐type DHFR and the simultaneous inhibition of both wild‐type and mutant DHFR molecules. Copyright © 1999 John Wiley & Sons, Ltd.

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Hyper-CVAD and high-dose methotrexate/cytarabine followed by stem-cell transplantation: an active regimen for aggressive mantle-cell lymphoma.

Abstract: The Hyper-CVAD/MTX-Ara-C program followed by stem-cell transplantation is a promising new therapy for previously untreated patients with MCL.

Cited by 325 publications

References 23 publications

Stem cell transplantation for mantle cell lymphoma: should it ever be used outside clinical trials?

Stem cell transplantation for mantle cell lymphoma: should it ever be used outside clinical trials?

Long-term progression-free survival after early autologous transplantation for mantle-cell lymphoma

Molecular modelling of trimethoprim complexes of human wild-type and mutant dihydrofolate reductases: identification of two subsets of binding residues in the antifolate binding site

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