Mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) followed by autologous stem cell transplantation for patients with chemosensitive aggressive non-Hodgkin lymphoma

Ji Won Kim, Hyun Jung Lee, Hyeon Gyu Yi, Byung Su Kim, Soo Mee Bang, Jin Seok Kim, Inho Kim, Sung-Soo Yoon, Jong-Seok Lee, Chul Soo Kim, Seonyang Park, Byoung Kook Kim

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Abstract

Patients with chemosensitive aggressive non-Hodgkin lymphoma (NHL) could benefit from high-dose chemotherapy (HDC) followed by autologous stem cell transplantation (auto-SCT). We report clinical outcomes of HDC using a novel regimen consisting of mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) with auto-SCT. A total of 69 patients were consecutively enrolled. Median age was 42 years (range, 20-66 years). Median event-free survival (EFS) was 17.9 months. Median overall survival (OS) has not been reached yet and estimated 2-year OS was 64.2%. Among patients with measurable lesions, response rate was 79.5%. Median time to recovery of neutrophil (>500 mL) and platelet (gt;20,000 mL) was 12.5 and 13.5 days, respectively. Febrile neutropenia developed in 61 patients (88.4%). Grades 3 or 4 hepatic toxicity developed in 7 patients (10.1%), Grades 3 or 4 renal toxicity in 2 patients (2.9%), and Grade 3 or 4 cardiac toxicity in 2 patients (2.9%). Transplant-related mortality (TRM) developed in two patients (2.9%). Multiple prior treatments before transplantation, auxiliary bone marrow harvest for stem cell collection, and high serum lactate dehydrogenase level were related to unfavorable treatment outcomes. In conclusion, NEAM conditioning with auto-SCT demonstrated considerable efficacy with modest toxicity in patients with chemosensitive aggressive NHL.

Original languageEnglish
Pages (from-to)479-483
Number of pages5
JournalAmerican Journal of Hematology
Volume87
Issue number5
DOIs
StatePublished - 1 May 2012

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Mitoxantrone
Melphalan
Cytarabine
Stem Cell Transplantation
Etoposide
Non-Hodgkin's Lymphoma
Drug Therapy
Febrile Neutropenia
Survival
Bone Marrow Transplantation
L-Lactate Dehydrogenase
Disease-Free Survival
Neutrophils
Stem Cells
Blood Platelets
Transplants
Kidney
Mortality
Liver

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title = "Mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) followed by autologous stem cell transplantation for patients with chemosensitive aggressive non-Hodgkin lymphoma",
abstract = "Patients with chemosensitive aggressive non-Hodgkin lymphoma (NHL) could benefit from high-dose chemotherapy (HDC) followed by autologous stem cell transplantation (auto-SCT). We report clinical outcomes of HDC using a novel regimen consisting of mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) with auto-SCT. A total of 69 patients were consecutively enrolled. Median age was 42 years (range, 20-66 years). Median event-free survival (EFS) was 17.9 months. Median overall survival (OS) has not been reached yet and estimated 2-year OS was 64.2{\%}. Among patients with measurable lesions, response rate was 79.5{\%}. Median time to recovery of neutrophil (>500 mL) and platelet (gt;20,000 mL) was 12.5 and 13.5 days, respectively. Febrile neutropenia developed in 61 patients (88.4{\%}). Grades 3 or 4 hepatic toxicity developed in 7 patients (10.1{\%}), Grades 3 or 4 renal toxicity in 2 patients (2.9{\%}), and Grade 3 or 4 cardiac toxicity in 2 patients (2.9{\%}). Transplant-related mortality (TRM) developed in two patients (2.9{\%}). Multiple prior treatments before transplantation, auxiliary bone marrow harvest for stem cell collection, and high serum lactate dehydrogenase level were related to unfavorable treatment outcomes. In conclusion, NEAM conditioning with auto-SCT demonstrated considerable efficacy with modest toxicity in patients with chemosensitive aggressive NHL.",
author = "Kim, {Ji Won} and Lee, {Hyun Jung} and Yi, {Hyeon Gyu} and Kim, {Byung Su} and Bang, {Soo Mee} and Kim, {Jin Seok} and Inho Kim and Sung-Soo Yoon and Jong-Seok Lee and Kim, {Chul Soo} and Seonyang Park and Kim, {Byoung Kook}",
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Mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) followed by autologous stem cell transplantation for patients with chemosensitive aggressive non-Hodgkin lymphoma. / Kim, Ji Won; Lee, Hyun Jung; Yi, Hyeon Gyu; Kim, Byung Su; Bang, Soo Mee; Kim, Jin Seok; Kim, Inho; Yoon, Sung-Soo; Lee, Jong-Seok; Kim, Chul Soo; Park, Seonyang; Kim, Byoung Kook.

In: American Journal of Hematology, Vol. 87, No. 5, 01.05.2012, p. 479-483.

Research output: Contribution to journalArticle

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AU - Kim, Chul Soo

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AU - Kim, Byoung Kook

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