PMID- 30197327
OWN - NLM
STAT- MEDLINE
DCOM- 20181102
LR  - 20220321
IS  - 1998-4138 (Electronic)
IS  - 1998-4138 (Linking)
VI  - 14
IP  - 5
DP  - 2018 Jul-Sep
TI  - Lomustine, cytarabine, cyclophosphamide, etoposide - An effective conditioning 
      regimen in autologous hematopoietic stem cell transplant for primary refractory 
      or relapsed lymphoma: Analysis of toxicity, long-term outcome, and prognostic 
      factors.
PG  - 926-933
LID - 10.4103/0973-1482.181183 [doi]
AB  - BACKGROUND: High-dose chemotherapy followed by autologous hematopoietic stem cell 
      transplant (HSCT) is the treatment of choice for patients with relapsed and 
      refractory (RR) lymphoma. We analyzed toxicity and long-term outcome with 
      lomustine, cytarabine, cyclophosphamide, etoposide (LACE) conditioning in 
      patients with primary refractory or relapsed lymphoma undergoing autologous 
      transplant. MATERIALS AND METHODS: One-hundred patients with primary refractory 
      (23), chemotherapy sensitive relapse (74) or RR (3) Hodgkin lymphoma (HL - 70 
      patients), and non-HL (NHL - 30 patients) underwent HSCT with LACE (lomustine 200 
      mg/m (2) day-7, etoposide 1000 mg/m (2) day-7, cytarabine 2000 mg/m (2) day-6 to 
      day-5, and cyclophosphamide 1800 mg/m (2) day-4 to day-2) conditioning between 
      November 2007 and December 2013. At transplant, 68 patients were in complete 
      remission (CR), 29 in partial remission, 2 had stable disease, and 1 had 
      progressive disease. Patients were followed up for development of 
      transplant-related toxicities and long-term survival outcome. RESULTS: The 
      incidence of grades 3-4 oral mucositis and grades 3-4 diarrhea was 8% and 4%, 
      respectively. Median days to myeloid and platelet engraftment were 10 and 13. 
      Transplant-related mortality was 7%. At median follow-up of 3 years, probability 
      of overall survival (OS) and progression-free survival (PFS) at 3 years was 70% 
      and 58% in entire cohort, 78% and 62% in HL and 51% and 46% in NHL subgroup, 
      respectively. International Prognostic Score (IPS) >2 at relapse prognosticated 
      for poor OS (P = 0.002) and PFS (P < 0.001) in HL subgroup. Positron emission 
      tomography positivity pretransplant (HL subgroup) and at day + 100 (NHL subgroup) 
      predicted for poor survival. CONCLUSION: We conclude that LACE is effective and 
      well-tolerated conditioning regimen. IPS at relapse is the most important 
      prognostic factor in HL transplant.
FAU - Gupta, Alok
AU  - Gupta A
AD  - Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata 
      Memorial Centre, Mumbai, Maharashtra, India.
FAU - Gokarn, Anant
AU  - Gokarn A
AD  - Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata 
      Memorial Centre, Mumbai, Maharashtra, India.
FAU - Rajamanickam, Deepan
AU  - Rajamanickam D
AD  - Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata 
      Memorial Centre, Mumbai, Maharashtra, India.
FAU - Punatar, Sachin
AU  - Punatar S
AD  - Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata 
      Memorial Centre, Mumbai, Maharashtra, India.
FAU - Thippeswamy, Ravi
AU  - Thippeswamy R
AD  - Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata 
      Memorial Centre, Mumbai, Maharashtra, India.
FAU - Mathew, Libin
AU  - Mathew L
AD  - Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata 
      Memorial Centre, Mumbai, Maharashtra, India.
FAU - Bagal, Bhausaheb
AU  - Bagal B
AD  - Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata 
      Memorial Centre, Mumbai, Maharashtra, India.
FAU - Kannan, Sadhana
AU  - Kannan S
AD  - Department of Biostatistics, ACTREC, Tata Memorial Centre, Mumbai, Maharashtra, 
      India.
FAU - Khattry, Navin
AU  - Khattry N
AD  - Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata 
      Memorial Centre, Mumbai, Maharashtra, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - J Cancer Res Ther
JT  - Journal of cancer research and therapeutics
JID - 101249598
RN  - 04079A1RDZ (Cytarabine)
RN  - 6PLQ3CP4P3 (Etoposide)
RN  - 7BRF0Z81KG (Lomustine)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/adverse 
      effects
MH  - Child
MH  - Child, Preschool
MH  - Cyclophosphamide/administration & dosage
MH  - Cytarabine/administration & dosage
MH  - Disease-Free Survival
MH  - Etoposide/administration & dosage
MH  - Female
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Hodgkin Disease/pathology/therapy
MH  - Humans
MH  - Lomustine/administration & dosage
MH  - Lymphoma/pathology/*therapy
MH  - Lymphoma, Non-Hodgkin/pathology/therapy
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/pathology/*therapy
MH  - *Prognosis
MH  - Recurrence
MH  - Remission Induction
MH  - Transplantation Conditioning
MH  - Transplantation, Autologous
MH  - Young Adult
OTO - NOTNLM
OT  - Conditioning regimen
OT  - Hodgkin lymphoma
OT  - hematopoietic stem cell transplantation
OT  - non-Hodgkin lymphoma
OT  - prognostic factors
COIS- There are no conflicts of interest
EDAT- 2018/09/11 06:00
MHDA- 2018/11/06 06:00
CRDT- 2018/09/11 06:00
PHST- 2018/09/11 06:00 [entrez]
PHST- 2018/09/11 06:00 [pubmed]
PHST- 2018/11/06 06:00 [medline]
AID - JCanResTher_2018_14_5_926_181183 [pii]
AID - 10.4103/0973-1482.181183 [doi]
PST - ppublish
SO  - J Cancer Res Ther. 2018 Jul-Sep;14(5):926-933. doi: 10.4103/0973-1482.181183.