Geisler CH et al. - In a trial to assess the use of intensive immunochemotherapy with stem-cell support in a large, prospective series in mantle cell lymphoma (MCL), it was shown that this approach can lead to long-term progression-free survival of MCL and perhaps cure Methods
160 consecutive, untreated pts <66 years of age were treated in a phase-II protocol with dose-intensified induction immunochemotherapy with rituximab (R) + cyclophosphamide, vincristine, doxorubicin, prednisone (maxi-CHOP) alternating with R + high-dose cytarabine
Responders received high-dose chemotherapy with BEAM or BEAC (carmustine, etoposide, cytarabine, and melphalan/cyclophosphamide) with R-in-vivo purged autologous stem-cell support
Results
Overall and complete response was achieved in 96% and 54%, respectively
Projected 6-year overall, event-free, and progression-free survival were 70%, 56%, and 66%, respectively, with no relapses occurring after 5 years
Multivariate analysis showed ki-67 to be the sole independent predictor of event-free survival
Non-relapse mortality was 5%
The majority of stem cell products and patients assessed with PCR posttransplant were negative
Compared with historical controls, the event-free, overall and progression-free survival, the duration molecular remission and the proportion of PCR-negative stem-cell products were significantly increased
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