International Journal of Hematology

DOI: 10.1007/s12185-018-2508-1 Pages: 1-6

Safety and efficacy of high-dose ranimustine (MCNU) containing regimen followed by autologous stem cell transplantation for diffuse large B-cell lymphoma

1. Akita University, Department of Hematology, Nephrology and Rheumatology

2. Aomori Prefectural Central Hospital, Department of Hematology

3. Iwate Medical University, Department of Hematology and Oncology

4. Fukushima Medical University, Department of Cardiology and Hematology

5. Yamagata University, Department of Hematology

6. Miyagi Cancer Center, Department of Hematology

7. Tohoku University, Department of Hemato-pathology

8. Tohoku University, Department of Hematology and Rheumatology

Correspondence to:
Yoshihiro Kameoka
Tel: +81-18-884-6116
Email: ykameoka@doc.med.akita-u.ac.jp

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Abstract

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is widely used as a salvage therapy for relapsed or high-risk diffuse large B-cell lymphoma (DLBCL). To investigate the safety and efficacy of regimens including high-dose MCNU followed by ASCT for DLBCL, we analyzed the data from prospective multicenter trials. Twenty-nine patients were analyzed, and the median follow-up time for survival patients was 70 months. Fifteen patients received MCVC conditioning regimen, and fourteen patients received MEAM regimen. Major toxicities associated with these conditioning regimens included nausea (69%), anorexia (66%), febrile neutropenia (62%), diarrhea (59%), and mucositis (34%). One patient who developed severe sinusoidal obstructive syndrome and acute lung injury died without disease progression, and overall therapy-related mortality at 5 years was 3%. No patient developed therapy-related hematological malignancy. At 5 years, overall survival and progression-free survival in all patients were 82.8 and 58.2%, respectively. The 5-year OS in patients treated by the MCVC and MEAM regimens were 73.3 and 92.9%, respectively. These results suggest that regimens including high-dose MCNU followed by ASCT are feasible and effective for the treatment of relapsed or high-risk DLBCL. Further investigation is needed to evaluate of these regimens.

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