Long-Term Survival and Late-Onset Complications of Cancer Patients Treated With High-Dose Chemotherapy Followed by Autologous Peripheral Blood Stem Cell Transplantation

  • Kyuhei Kohda
  • Sumio Sakamaki
  • Takuya Matsunaga
  • Takashi Kuga
  • Akihito Fujimi
  • Yuichi Konuma
  • Toshiro Kusakabe
  • Katsuhisa Kogawa
  • Takehide Akiyama
  • Kazuhiko Koike
  • Yasuo Hirayama
  • Yutaka Sasagawa
  • Syuichi Nojiri
  • Yasuji Hirata
  • Takuji Nishisato
  • Yoshiro Niitsu
  • Hokkaido Society of Peripheral Blood Stem Cell Transplantation
Case Report

DOI: 10.1007/BF02981946

Cite this article as:
Kohda, K., Sakamaki, S., Matsunaga, T. et al. Int J Hematol (2001) 73: 251. doi:10.1007/BF02981946

Abstract

The antitumor effect of high-dose chemotherapy (HDC) followed by autologous peripheral blood stem cell transplantation (auto-PBSCT) is considered superior to that of conventional chemotherapy. However, the long-term benefits of this strategy in Japan remain unclear.Therefore, in this study, 109 cancer patients enrolled between 1989 and 1999 were treated with HDC and auto-PBSCT. Patients were evaluated for long-term survival and late-onset complications, including secondary malignancy. The mean number of CD34+ cells harvested per apheresis was larger in the group receiving high-dose cytosine arabinoside or high-dose etoposide plus granulocyte colony-stimulating factor (G-CSF) than in the group receiving conventional chemotherapy plus G-CSF. The 5-year overall survival rates for non-Hodgkin’s lymphoma patients in first complete remission (CR) (83.2%), second or subsequent CR (74.1%), or first partial remission (PR) (66.7%) at the time of transplantation were significantly higher than those with no remission (35.7%) at the time of transplantation (first CR,P < .05; second or subsequent CR,P < .05; first PR,P < .05). The 5-year overall survival (OS) rates for breast cancer was 40.8%, and the disease-free survival rate was extremely low (8.8%). The 5-year OS rates for chemotherapy-sensitive and chemotherapy-resistant diseases at the time of transplantation were 32.7% and 35.7%, respectively, a difference that was not considered significant. The 5-year OS for germ cell tumor was 80.0%, and the disease-free survival rate was 77.9%. The rate of therapy-related death was 8.2%. The occurrence rate of secondary malignancy was 0.9%. Late-onset complications were observed in 4 cases (glomerulonephritis, interstitial pneumonitis, ulcerative colitis, and acute myelogenous leukemia). At 3.7%, the occurrence rate was not very high, but most complications of auto-PBSCT were life threatening and interfered with patients’ quality of life. A careful follow-up is required for at least 2 years after transplantation, because the mean occurrence time of late-onset complications is 16.7 months posttransplantation.

Key words

High-dose chemotherapyauto-PBSCTSecondary malignancySolid tumorG-CSF

Copyright information

© The Japanese Society of Hematology 2001

Authors and Affiliations

  • Kyuhei Kohda
    • 1
  • Sumio Sakamaki
    • 2
  • Takuya Matsunaga
    • 2
  • Takashi Kuga
    • 1
  • Akihito Fujimi
    • 2
  • Yuichi Konuma
    • 2
  • Toshiro Kusakabe
    • 2
  • Katsuhisa Kogawa
    • 2
  • Takehide Akiyama
    • 1
  • Kazuhiko Koike
    • 1
  • Yasuo Hirayama
    • 3
  • Yutaka Sasagawa
    • 4
  • Syuichi Nojiri
    • 5
  • Yasuji Hirata
    • 6
  • Takuji Nishisato
    • 7
  • Yoshiro Niitsu
    • 2
  • Hokkaido Society of Peripheral Blood Stem Cell Transplantation
  1. 1.Japanese Red Cross Asahikawa HospitalJapan
  2. 2.Fourth Department of Internal MedicineSapporo Medical University School of MedicineJapan
  3. 3.Hokkaido Prefectural Sapporo Kitano HospitalJapan
  4. 4.Rumoi City HospitalJapan
  5. 5.Muroran Sin Nittetsu HospitalJapan
  6. 6.Hakodate National HospitalJapan
  7. 7.Sapporo Kiyota HospitalJapan
  8. 8.Fourth Department of Internal MedicineSapporo Medical University School of MedicineSapporoJapan