International Journal of Hematology

, Volume 96, Issue 5, pp 624–630

Safety and feasibility of high-dose ranimustine (MCNU), carboplatin, etoposide, and cyclophosphamide (MCVC) therapy followed by autologous stem cell transplantation for malignant lymphoma

Verlag Dr. Kovac, ISBN: 978-3-8300-6328-5, 98,80 €
  • Yoshihiro Kameoka
  • Naoto Takahashi
  • Kenichi Ishizawa
  • Yuichi Kato
  • Jugo Ito
  • Osamu Sasaki
  • Kazunori Murai
  • Hideyoshi Noji
  • Makoto Hirokawa
  • Katsusi Tajima
  • Tsutomu Shichishima
  • Yoji Ishida
  • Hideo Harigae
  • Kenichi Sawada
Original Article

DOI: 10.1007/s12185-012-1186-7

Cite this article as:
Kameoka, Y., Takahashi, N., Ishizawa, K. et al. Int J Hematol (2012) 96: 624. doi:10.1007/s12185-012-1186-7

Abstract

High-dose chemotherapy followed by autologous stem cell transplantation (auto-SCT) is widely used as a salvage therapy in the treatment of refractory malignant lymphoma. To investigate the safety and feasibility of a high-dose MCNU, carboplatin, etoposide and cyclophosphamide (MCVC) regimen, we conducted a prospective multicenter trial. Thirty patients with relapsed/refractory/poor-risk non-Hodgkin lymphoma (NHL n = 27) or Hodgkin lymphoma (HD n = 3) were uniformly treated with an MCVC regimen and underwent auto-SCT. The median follow-up duration of the surviving patients was 67 months (56–133 months). The major toxicities were anorexia (94 %), diarrhea (80 %), nausea (79 %), febrile neutropenia (70 %), alopecia (67 %) and mucositis (60 %). Three patients developed severe left ventricular dysfunction, and two patients developed severe sinusoidal obstructive syndrome (SOS). Of these patients, two died without disease progression. Treatment-related mortality was 6.6 %. Late-onset adverse events including two cases of cytomegalovirus pneumonia and one of interstitial pneumonia were observed. In DLBCL (n = 13) and transformed FL (n = 2) patients, OS and EFS at 3 years were 72 and 46 %, respectively. These results suggest that the MCVC regimen followed by auto-SCT is a feasible and tolerable therapy for relapsed/refractory malignant lymphoma. However, cardiac toxicity due to high-dose cyclophosphamide and development of SOS can occur and should be carefully monitored. Further follow-up is needed to evaluate the long-term efficacy and safety of this regimen.

Keywords

MCVCMalignant lymphomaAuto-SCTFeasibilitySafety

Copyright information

© The Japanese Society of Hematology 2012

Authors and Affiliations

  • Yoshihiro Kameoka
    • 1
    • 9
  • Naoto Takahashi
    • 1
  • Kenichi Ishizawa
    • 8
  • Yuichi Kato
    • 3
  • Jugo Ito
    • 4
  • Osamu Sasaki
    • 5
  • Kazunori Murai
    • 6
  • Hideyoshi Noji
    • 7
  • Makoto Hirokawa
    • 2
  • Katsusi Tajima
    • 3
  • Tsutomu Shichishima
    • 7
  • Yoji Ishida
    • 6
  • Hideo Harigae
    • 8
  • Kenichi Sawada
    • 1
  1. 1.Department of HematologyAkita University Graduate School of MedicineAkitaJapan
  2. 2.School of MedicineAkita UniversityAkitaJapan
  3. 3.3rd Department of Internal MedicineYamagata UniversityYamagataJapan
  4. 4.Department of OncologyHirosaki UniversityHirosakiJapan
  5. 5.Division of HematologyMiyagi Cancer CenterNatoriJapan
  6. 6.School of Medical Hematology and OncologyIwate Medical UniversityMoriokaJapan
  7. 7.Department of Cardiology and HematologyFukushima Medical UniversityFukushimaJapan
  8. 8.Hematology and RheumatologyTohoku University Graduate School of MedicineSendaiJapan
  9. 9.Division of Hematology and Oncology, Department of Internal MedicineAkita University School of MedicineAkitaJapan