Tandem cycles of high-dose chemotherapy with peripheral blood progenitor cell rescue for patients with relapsed or high risk lymphoma.

N Raja, WE Miller, R McMillan, MP Kosty, A Saven, BR Meisenberg, JR Mason


Tandem cycles of HDC with PBPCR to obtain optimal dose intensity are increasingly used to treat patients (pts) with lymphoma. We treated pts with relapsed or high-risk lymphoma with tandem cycles of HDC as follows: Cycle 1 - cyclophosphamide 6000 mg/m2, etoposide 1500 mg/m2 and carboplatin 1200 mg/m2; Cycle 2 - mitoxantrone 60 mg/m2 and thiotepa 600 mg/m2 or melphalan 140 mg/m2 and carboplatin 1200 mg/m2. Each cycle was followed by PBPCR. Of 37 pts treated, 23 (62%) were male. Their median age was 44 years (y), (range, 19-67 y). The histologies were as follows: intermediate-grade non-Hodgkin's lymphoma (NHL) 25 pts (68%), low-grade NHL four pts (11%), high-grade NHL four pts (11%) and Hodgkin's disease three pts (8%). Nineteen pts (52%) received both cycles of HDC. Reasons for not receiving the second cycle: patient (pt) refusal and lack of insurance coverage (11 pts), progressive disease after one cycle (five pts), inadequate collection of stem cells (one pt) and prolonged hematopoietic recovery (one pt). The principal grade IV non-hematologic toxicities were: mucositis (11 pts) and bacteremia (three pts). There were two toxic deaths, one each due to pulmonary aspergillosis and cardiomyopathy.

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39th meeting of the American Society for Haemotology
    • ASH 39th (1998)