Multicenter analysis of treatment outcomes in adult patients with lymphoblastic lymphoma who received hyper-CVAD induction followed by hematopoietic stem cell transplantation

Seong Hyun Jeong, Joon Ho Moon, Jin Seok Kim, Deok Hwan Yang, Yong Park, Seok Goo Cho, Jae Yong Kwak, Hyeon Seok Eom, Jong Ho Won, Jun Shik Hong, Sung Yong Oh, Ho Sup Lee, Seok Jin Kim

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Abstract

The hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen has been widely used for lymphoblastic lymphoma (LBL) as a primary treatment. However, there is few data about its treatment outcome in Asian patients. Thus, we conducted this study to evaluate the efficacy of hyper-CVAD induction and stem cell transplantation (SCT) consolidation in LBL patients. The treatment responses of 49 patients treated with the hyper-CVAD regimen were retrospectively analyzed in 13 institutions. Given 24 patients who responded to hyper-CVAD underwent consolidation treatment with SCT, overall survival (OS) and progression-free survival (PFS) of patients who received SCT were compared with patients who did not. The overall response rate was 79 %: 73 % (36/49) complete responses, 6 % (3/49) partial responses, and 4 % (2/49) induction deaths. The major limitation for the delivery of the planned hyper-CVAD cycles was hematological toxicity. Among 39 responders, 24 patients underwent autologous (n = 16) and allogeneic SCT (n = 8) consolidation. Their 3-year OS and PFS rates were 76 and 78 %, respectively, and there was no difference in survival outcomes between autologous and allogeneic SCT. However, 15 patients without SCT consolidation showed poorer PFS even though they all achieved complete response. Thus, only seven patients maintained their response at the time of analysis. In conclusion, the hyper-CVAD regimen is effective for remission induction in LBL, and SCT consolidation after hyper-CVAD induction produced better clinical outcomes than did continuation of hyper-CVAD.

Original languageEnglish
Pages (from-to)617-625
Number of pages9
JournalAnnals of Hematology
Volume94
Issue number4
DOIs
Publication statusPublished - 2015 Mar 6

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Hematopoietic Stem Cell Transplantation
Vincristine
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Doxorubicin
Cyclophosphamide
Dexamethasone
Stem Cell Transplantation
Disease-Free Survival
Survival
Remission Induction
Therapeutics
Survival Rate

Keywords

  • Hyper-CVAD
  • Lymphoblastic lymphoma
  • Stem cell transplantation

ASJC Scopus subject areas

  • Hematology

Cite this

Multicenter analysis of treatment outcomes in adult patients with lymphoblastic lymphoma who received hyper-CVAD induction followed by hematopoietic stem cell transplantation. / Jeong, Seong Hyun; Moon, Joon Ho; Kim, Jin Seok; Yang, Deok Hwan; Park, Yong; Cho, Seok Goo; Kwak, Jae Yong; Eom, Hyeon Seok; Won, Jong Ho; Hong, Jun Shik; Oh, Sung Yong; Lee, Ho Sup; Kim, Seok Jin.

In: Annals of Hematology, Vol. 94, No. 4, 06.03.2015, p. 617-625.

Research output: Contribution to journalArticle

Jeong, Seong Hyun ; Moon, Joon Ho ; Kim, Jin Seok ; Yang, Deok Hwan ; Park, Yong ; Cho, Seok Goo ; Kwak, Jae Yong ; Eom, Hyeon Seok ; Won, Jong Ho ; Hong, Jun Shik ; Oh, Sung Yong ; Lee, Ho Sup ; Kim, Seok Jin. / Multicenter analysis of treatment outcomes in adult patients with lymphoblastic lymphoma who received hyper-CVAD induction followed by hematopoietic stem cell transplantation. In: Annals of Hematology. 2015 ; Vol. 94, No. 4. pp. 617-625.
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AU - Moon, Joon Ho

AU - Kim, Jin Seok

AU - Yang, Deok Hwan

AU - Park, Yong

AU - Cho, Seok Goo

AU - Kwak, Jae Yong

AU - Eom, Hyeon Seok

AU - Won, Jong Ho

AU - Hong, Jun Shik

AU - Oh, Sung Yong

AU - Lee, Ho Sup

AU - Kim, Seok Jin

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AB - The hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen has been widely used for lymphoblastic lymphoma (LBL) as a primary treatment. However, there is few data about its treatment outcome in Asian patients. Thus, we conducted this study to evaluate the efficacy of hyper-CVAD induction and stem cell transplantation (SCT) consolidation in LBL patients. The treatment responses of 49 patients treated with the hyper-CVAD regimen were retrospectively analyzed in 13 institutions. Given 24 patients who responded to hyper-CVAD underwent consolidation treatment with SCT, overall survival (OS) and progression-free survival (PFS) of patients who received SCT were compared with patients who did not. The overall response rate was 79 %: 73 % (36/49) complete responses, 6 % (3/49) partial responses, and 4 % (2/49) induction deaths. The major limitation for the delivery of the planned hyper-CVAD cycles was hematological toxicity. Among 39 responders, 24 patients underwent autologous (n = 16) and allogeneic SCT (n = 8) consolidation. Their 3-year OS and PFS rates were 76 and 78 %, respectively, and there was no difference in survival outcomes between autologous and allogeneic SCT. However, 15 patients without SCT consolidation showed poorer PFS even though they all achieved complete response. Thus, only seven patients maintained their response at the time of analysis. In conclusion, the hyper-CVAD regimen is effective for remission induction in LBL, and SCT consolidation after hyper-CVAD induction produced better clinical outcomes than did continuation of hyper-CVAD.

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