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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted May 29, 2008 Accepted September 28, 2008 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. Final results with a median follow-up of nine years Emmanuel Gyan, Charles Foussard, Philippe Bertrand, Patrick Michenet, Steven Le Gouill, Christian Berthou, Herve Maisonneuve, Vincent Delwail, Remi Gressin, Philippe Quittet, Jean-Pierre Vilque, Bernard Desablens, Jerome Jaubert, Jean-Francois Ramee, Nina Arakelyan, Antoine Thyss, Cecile Molucon-Chabrot, Roselyne Delepine, Noel Milpied, Philippe Colombat, and Eric Deconinck* Department of Hematology, Bretonneau University Hospital, Tours, France Department of Hematology, University Hospital, Angers, France Department of Biostatistics, Faculty of Medicine, Tours, France Department of Pathology, Centre Hospitalier, Orleans, France Department of Hematology, University Hospital of Nantes, Nantes, France Department of Hematology, University Hospital, Brest, France Department of Hematology, Centre Hospitalier, La Roche-sur-Yon, France Department of Hematology, University Hospital of Poitiers, Jean Bernard Hospital, Poitiers, France Department of Hematology, University Hospital, Grenoble, France Department of Hematology, University Hospital, Montpellier, France Francois Baclesse Anticancer Center, Caen, France Department of Hematology, University Hospital, Amiens, France Department of Hematology, University Hospital, Saint-Etienne, France Department of Hematology, Catherine de Sienne Clinic, Nantes, France Department of Hematology, Georges Pompidou European Hospital, Paris, France Antoine Lacassagne Anticancer Center, Nice, France Department of Hematology, University Hospital, Clermont-Ferrand, France Department of Hematology, University Hospital, Bordeaux, France INSERM U645, Franche-Comte University; Department of Hematology, Jean Minjoz Hospital, Besancon, France * Corresponding author; email: edeconinck{at}chu-besancon.fr. The role of autologous stem cell transplantation (ASCT) as first-line therapy for follicular lymphoma (FL) remains controversial. The multicenter 064 study of the GOELAMS, randomized 172 patients with untreated FL for either immunochemotherapy or high-dose therapy (HDT) followed by purged ASCT (Blood. 2005;105:3817-3823). Conditioning was performed with total body irradiation (TBI) and cyclophosphamide. With long-term follow-up, the 9-year OS was similar in the HDT and chemotherapy groups (76% and 80%, respectively). The 9-year PFS was higher in the ASCT than the chemotherapy group (64% vs. 39%; p=0.004). A PFS plateau was observed in the HDT group after 7 years. On multivariate analysis, OS and PFS were independently affected by the ECOG performance status score and the number of nodal areas involved. PFS was also affected by treatment group. Secondary malignancies were more frequent in the HDT than in the chemotherapy group (6 secondary MDS/AML and 6 second cancers 12 vs. 1 AML, p=0.01). In conclusion, the occurrence of a PFS plateau suggests that a subgroup of patients might be 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. 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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