NEJM study evaluates early stem cell transplants for non-Hodgkin's lymphoma

PUBLIC RELEASE DATE:

30-Oct-2013

Contact: Jim Ritter jritter@lumc.edu 708-216-2445 Loyola University Health System

MAYWOOD, Ill. Performing early stem cell transplants in patients with aggressive non-Hodgkin's lymphoma does not improve overall survival in high-risk patients, according to a study published in the New England Journal of Medicine.

But early transplantation does appear to be beneficial among a small group of patients who are at the very highest risk, the study found.

Lead author is Patrick Stiff, MD, director of Loyola University Medical Center's Cardinal Bernardin Cancer Center. The study was developed by the SWOG cancer research cooperative group and funded by the National Cancer Institute. Stiff is chair of the SWOG Bone Marrow and Stem Cell Transplantation Committee.

The traditional first-line therapy for aggressive non-Hodgkin's lymphoma is a combination of four chemotherapy drugs. In recent years, physicians have added a fifth drug, the monoclonal antibody rituximab. This five-drug regimen is known as R-CHOP. The treatment typically puts patients into remission. But many patients relapse and go on to get an autologous stem cell transplant after second-line chemotherapy.

The study was designed to determine whether doing an early stem cell transplant without first waiting to see whether a patient relapses -- would increase survival.

The clinical trial included 40 sites in the United States and Canada. In addition to SWOG, the study included the Eastern Cooperative Oncology Group, Cancer and Leukemia Group B and Canadian NCIC Clinical Trials Group.

The study included 397 patients who were in defined groups of high risk or intermediate-high risk of relapsing. After initial chemotherapy, those who responded were randomly assigned to receive an autologous stem cell transplant (125 patients) or to a control group of 128 patients who received three additional cycles of the R-CHOP regimen. Enrollment began in 1999 and ended in 2007. (Some of the patients in the beginning of the study did not receive rituximab.)

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NEJM study evaluates early stem cell transplants for non-Hodgkin's lymphoma

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