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Blood, 29 January 2009, Vol. 113, No. 5, pp. 995-1001. Prepublished online as a Blood First Edition Paper on October 27, 2008; DOI 10.1182/blood-2008-05-160200. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2008-05-160200v1 113/5/995    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Gyan, E. Articles by Deconinck, E. Search for Related Content PubMed PubMed Citation Articles by Gyan, E. Articles by Deconinck, E. Related Collections Transplantation Free Research Articles Lymphoid Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS High-dose therapy followed by autologous purged stem cell transplantation and doxorubicin-based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS with final results after a median follow-up of 9 years Emmanuel Gyan1, Charles Foussard2, Philippe Bertrand3, Patrick Michenet4, Steven Le Gouill5, Christian Berthou6, Hervé Maisonneuve7, Vincent Delwail8, Rémi Gressin9, Philippe Quittet10, Jean-Pierre Vilque11, Bernard Desablens12, Jérôme Jaubert13, Jean-François Ramée14, Nina Arakelyan15, Antoine Thyss16, Cécile Moluçon-Chabrot17, Roselyne Delépine1, Noël Milpied18, Philippe Colombat1, Eric Deconinck19, for the Groupe Ouest-Est des Leucémies et des Autres Maladies du Sang (GOELAMS) 1 Department of Hematology, Bretonneau University Hospital, Tours; 2 Department of Hematology, University Hospital, Angers; 3 Department of Biostatistics, Faculty of Medicine, Tours; 4 Department of Pathology, Centre Hospitalier, Orléans; 5 Department of Hematology, University Hospital of Nantes, Nantes; 6 Department of Hematology, University Hospital, Brest; 7 Department of Hematology, Centre Hospitalier, La Roche-sur-Yon; 8 Department of Hematology, University Hospital of Poitiers, Jean Bernard Hospital, Poitiers; 9 Department of Hematology, University Hospital, Grenoble; 10 Department of Hematology, University Hospital of Montpellier, Montpellier; 11 François Baclesse Anticancer Center, Caen; 12 Department of Hematology, University Hospital, Amiens; 13 Department of Hematology, University Hospital, Saint-Etienne; 14 Department of Hematology, Catherine de Sienne Clinic, Nantes; 15 Department of Hematology, Georges Pompidou European Hospital, Paris; 16 Antoine Lacassagne Anticancer Center, Nice; 17 Department of Hematology, University Hospital, Clermont-Ferrand; 18 Department of Hematology, University Hospital of Bordeaux, Bordeaux; and 19 Inserm, U645, Franche-Comté University and Department of Hematology, Jean Minjoz Hospital, Besançon, France Autologous stem cell transplantation (ASCT) as first-line therapy for follicular lymphoma (FL) remains controversial. The multicenter study randomized 172 patients with untreated FL for either immunochemotherapy or high-dose therapy (HDT) followed by purged ASCT. Conditioning was performed with total body irradiation (TBI) and cyclophosphamide. The 9-year overall survival (OS) was similar in the HDT and conventional chemotherapy groups (76% and 80%, respectively). The 9-year progression-free survival (PFS) was higher in the ASCT than the chemotherapy group (64% vs 39%; P = .004). A PFS plateau was observed in the HDT group after 7 years. On multivariate analysis, OS and PFS were independently affected by the per-formance status score, the number of nodal areas involved, and the treatment group. Secondary malignancies were more frequent in the HDT than in the chemotherapy group (6 secondary myelodysplastic syndrome/acute myeloid leukemia and 6 second solid tumor cancers vs 1 acute myeloid leukemia, P = .01). The occurrence of a PFS plateau suggests that a subgroup of patients might have their FL cured by ASCT. However, the increased rate of secondary malignancies may discourage the use of purged ASCT in combination with TBI as first-line treatment for FL. This trial has been registered with ClinicalTrials.gov under identifier NCT00696735 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: Y. L. Kasamon, R. J. Jones, R. A. Brodsky, E. J. Fuchs, W. Matsui, L. Luznik, J. D. Powell, A. L. Blackford, A. Goodrich, C. D. Gocke, et al. Immunologic recovery following autologous stem-cell transplantation with pre- and posttransplantation rituximab for low-grade or mantle cell lymphoma Ann. Onc., October 30, 2009; (2009) mdp484v1. [Abstract] [Full Text] [PDF] A. J. Moskowitz and C. H. Moskowitz Controversies in the Treatment of Lymphoma with Autologous Transplantation Oncologist, September 1, 2009; 14(9): 921 - 929. [Abstract] [Full Text] [PDF] M. Foster, D. A. Gabriel, and T. Shea Role of Hematopoietic Stem Cell Transplant in the Management of Follicular Lymphoma Oncologist, July 1, 2009; 14(7): 726 - 738. [Abstract] [Full Text] [PDF]

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