scholarly journals Long-term outcomes after high dose therapy and autologous haematopoietic cell rescue for refractory/relapsed Hodgkin lymphoma

2012 ◽  
Vol 159 (3) ◽  
pp. 329-339 ◽  
Author(s):  
Ann Y. Minn ◽  
Elyn Riedel ◽  
Jerry Halpern ◽  
Laura J. Johnston ◽  
Sandra J. Horning ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
High Dose ◽  
Long Term Outcomes ◽  
High Dose Therapy ◽  
Dose Therapy ◽  
Haematopoietic Cell

Dose-Intensive Therapy for Limited-Stage Small-Cell Lung Cancer: Long-Term Outcome

1999 ◽  
Vol 17 (4) ◽  
pp. 1175-1175 ◽  
Author(s):  
Anthony Elias ◽  
Joseph Ibrahim ◽  
Arthur T. Skarin ◽  
Catherine Wheeler ◽  
Mary McCauley ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell ◽  
High Dose ◽  
Small Cell Lung ◽  
First Line ◽  
High Dose Therapy ◽  
Dose Intensification ◽  
Dose Therapy ◽  
Limited Stage

PURPOSE: To determine progression-free survival (PFS) and overall long-term survival for limited-stage small-cell lung cancer (SCLC) patients aged 60 years or younger who respond to first-line chemotherapy followed by high-dose combination alkylating agents (cyclophosphamide 5,625 mg/m2, cisplatin 165 mg/m2, and carmustine 480 mg/m2) with hematologic stem-cell support and chest and prophylactic cranial radiotherapy. PATIENTS AND METHODS: Patients were selected on the basis of their continued response to first-line therapy, their relative lack of significant comorbidity, and their ability to obtain financial clearance. RESULTS: Of 36 patients with stage III SCLC, nine patients (25%) had achieved a complete response (CR), 20 had achieved a near-CR, and seven had achieved a partial response before undergoing high-dose therapy. Toxicity included three deaths (8%). For all patients, the median PFS was 21 months. The 2- and 5-year survival rates after dose intensification were 53% (95% confidence interval [CI], 39% to 72%), and 41% (95% CI, 28% to 61%). Of the 29 patients who were in or near CR before undergoing high-dose therapy, 14 remain continuously progression-free a median of 61 months (range, 40 to 139 months) after high-dose therapy. Actuarial 2- and 5-year PFS rates were 57% (95% CI, 41% to 79%) and 53% (95% CI, 38% to 76%). By multivariate analysis, short intensive induction chemotherapy was associated with favorable outcome (P < .05). CONCLUSION: Use of high-dose systemic therapy with intensive local-regional radiotherapy was associated with manageable treatment-related morbidity and mortality. Patients who were in or near CR before intensification are enjoying an unmaintained 5-year PFS rate of 53%. Late complications were infrequent, and most patients returned to full-time work and activity. A randomized comparison of this approach and conventional-dose therapy should define the use of dose intensification with hematopoietic support in patients with responding limited-stage SCLC.

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