Faculty Collaboration Database

Excessive toxicity of the high dose thiotepa and etoposide regimen when combined with radiation: Long-term autologous transplantation experience in follicular and mantle cell lymphoma. Leuk Lymphoma 2005 Oct;46(10):1441-8

Date

10/01/2005

Pubmed ID

16194889

DOI

10.1080/10428190500144656

Scopus ID

2-s2.0-26944490733 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

We recently described a novel thiotepa plus etoposide high-dose therapy (HDT) conditioning regimen for aggressive histology non-Hodgkin's lymphoma (NHL) that had low regimen-related toxicity (RRT) and an efficacy rate comparable to other NHL HDT regimens. In this report, we describe the UW experience with the addition of total body irradiation (TBI) and pre-transplant involved-field radiation (IFRT) to the thiotepa + etoposide HDT regimen. Between 1992 and 1999, 28 patients with indolent or mantle cell lymphoma were treated on this protocol. With a median follow-up of 64 mo, the median event-free survival (EFS) was 24 months, and the median overall survival (OS) had not been reached. The median number of grade 3 - 4 non-hematologic toxicities was five. There were five deaths (18%) in the first three months after HDT due to RRT. In contrast, the thiotepa + etoposide conditioning regimen (without TBI or IFRT) given to 65 intermediate grade NHL patients resulted in only one treatment-related death and considerably fewer grade 3 - 4 toxicities. Given the relatively short EFS in this cohort of indolent NHL patients, we conclude that the combination of IFRT and TBI plus thiotepa and etoposide resulted in a HDT regimen with excessive toxicity and this protocol was closed at our institution.

Author List

Fenske TS, Kahl BS, Eickhoff J, Mitchell TL, Smith EP, Atkinson E, McCoy AG, Eckstein L, Flynn B, McMannes J, Howard S, Longo WL

Authors

Timothy Fenske MD Professor in the Medicine department at Medical College of Wisconsin
Walter L. Longo MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Combined Modality Therapy
Etoposide
Female
Follow-Up Studies
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, Follicular
Lymphoma, Mantle-Cell
Male
Middle Aged
Survival Rate
Thiotepa
Time Factors
Transplantation, Autologous