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Primary systemic CD30 (Ki-1)-positive anaplastic large cell lymphoma of the
adult: sequential intensive treatment with the F-MACHOP regimen (+/-
radiotherapy) and autologous bone marrow transplantation
R Fanin, F Silvestri, A Geromin, M Cerno, L Infanti, F Zaja, G Barillari, C Savignano, C Rinaldi, D Damiani, A Buffoli, F Biffoni and M Baccarini
Department of Bone Marrow Transplantation, University Hospital, Udine,
Italy.
Few series of adult patients with primary systemic CD30 (Ki-1)-positive
anaplastic large cell lymphoma (ALCL) are reported in the literature; most
of them have been treated with combination chemotherapy (CHT), with only an
occasional patient being autotransplanted, mainly after relapsing. The
remission rate ranges from 60% to 90%, but relapses are frequent (up to
60%) and precocious (mainly in the first 24 months). The aim of our study
was to analyze the outcome of a series of adult patients affected by
primary systemic ALCL that were treated at our institution with a
sequential intensive therapeutic program including CHT, radiotherapy (RT),
and autologous bone marrow transplantation (ABMT). Sixteen consecutive,
unselected patients with ALCL were identified. All of them were treated
with the 5-fluorouracil, methotrexate, cytosine arabinoside,
cyclophosphamide, doxorubicin, vincristine, and prednisone (F-MACHOP)
regimen; 9 of 16 (56.2%) reached a complete remission (CR). In six cases
with residual mediastinal disease, involved-field RT was performed,
allowing three additional patients to become free of disease. All 16 were
then autotransplanted with bone marrow stem cells after conditioning with
the cytosine arabinoside, etoposide, cyclophasphamide, and carmustine
(BAVC) regimen. A present, 16 of 16 patients are alive and in CR. The
actuarial overall survival is 100% at a median of 45.5 months, and the
actuarial disease-free survival is 100% at a median of 33.5 months. These
data suggest that ALCL can be successfully managed with a sequential
intensive treatment (CHT +/- RT + ABMT) that prevents early relapses and
projects these patients as long-term survivors.
Volume 87,
Issue 4,
pp. 1243-1248,
02/15/1996
Copyright © 1996 by The American Society of Hematology
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