In:
British Journal of Haematology, Wiley, Vol. 172, No. 1 ( 2016-01), p. 111-121
Abstract:
High‐dose chemotherapy ( HDT ) with autologous stem cell transplantation is the standard of care for relapsed/refractory ( RR ) Hodgkin lymphoma ( HL ). Given that HDT may cure a sizeable proportion of patients refractory to first salvage, development of newer conditioning regimens remains a priority. We present the results of a novel HDT regimen in which carmustine was substituted by a third‐generation chloroethylnitrosourea, fotemustine, with improved pharmacokinetics and safety ( FEAM ; fotemustine, etoposide, cytarabine, melphalan) in 122 patients with RR ‐ HL accrued into a prospective registry‐based study. Application of FEAM resulted in a 2‐year progression‐free survival ( PFS ) of 73·8% [95% confidence interval ( CI ), 0·64–0·81] with median PFS , overall survival and time to progression yet to be reached. The 2‐year risk of progression adjusted for the competitive risk of death was 19·4% (95% CI , 0·12–0·27) for the entire patient population. Most previously established independent risk factors, except for fluorodeoxyglucose ( 18 F FDG )‐uptake, were unable to predict for disease progression and survival after FEAM . Although 32% of patients had 18 F FDG ‐positrin emission tomography‐positive lesions before HDT , the 2‐year risk of progression adjusted for competitive risk of death was 19·4% (95% CI ; 0·12–0·27). No unusual acute toxicities or early/late pulmonary adverse events were registered. FEAM emerges as an ideal HDT regimen for RR ‐ HL patients typically pre‐exposed to lung‐damaging treatments.
Type of Medium:
Online Resource
ISSN:
0007-1048
,
1365-2141
DOI:
10.1111/bjh.2016.172.issue-1
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
1475751-5
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