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ctt-journal > Gorenkova et al. (Abstract)

Gorenkova et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract12

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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Clinical and molecular evaluation of the efficacy of the high-dose polychemotherapy in adult patients with anaplastic large-cell ALK-positive lymphoma

Liliya G. Gorenkova, Juliya E. Vinogradova, Sergey K. Kravchenko, Ekaterina A. Ilyushkina , Andrei V. Misurin

Hematology Research Center, Moscow, Russia

Correspondence: Liliya G. Gorenkova, Hematology Research Center, 4a, Novozykovskii pr., Moscow, 125167, Russia, E-mail: l.aitova@spam is badmail.ru

Abstract

Aims: To evaluate the efficacy of a high-dose NHL BFM-90 chemotherapy program in adult patients with anaplastic large-cell ALK-positive lymphoma (ALCL); to determine the prognostic significance of the minimal residual disease in blood and/or bone marrow samples by RT-PCR, and to evaluate the role of autologous stem cell transplantation.

Methods: Patients were older than 18 years, and diagnosed with ALCL. Blood and bone marrow samples were examined for the quantity of NPM-ALK transcripts by RT-PCR before starting the treatment and after the end of protocol NHL BFM 90.

Results: Twenty adult patients with ALCL were treated with the NHL BFM-90 protocol. Generalized lymphadenopathy was revealed in all patients, and 60% of the patients had extranodal sites, such as skin, subcutaneous tissues, bones, and lungs. Eighty percent of patients were diagnosed with stage III–IV disease. RT-PCR of NPM/ALK was employed to analyze the minimal residual disease level in all patients.  Patients with unfavorable prognostic factors and positive results on the minimal residual disease test received autologous stem cell blood transplantation. Complete remission was obtained in 19 patients. One patient died of infectious complications during the first course of polychemotherapy. Two patients with stage IV and skin involvement relapsed during the first year after the end of the treatment. One of them died of disease progression, and one relapsed patient achieved a second long-term remission after allogeneic bone marrow transplantation. Thus, the overall 5-year survival rate was 90%.

Conclusions: The use of the child protocol NHL BFM-90 has shown high efficacy in adult patients with ALCL compared with current chemotherapy regimes. The using of autologous stem cell transplantation may be rational in patients with poor clinical and molecular prognostic factors.

Keywords: anaplastic large cell lymphoma, adults, high-dose polychemotherapy, protocol NHL BFM-90, autologous stem cell transplantation, minimal residual disease