Myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission prolongs progression-free survival in follicular lymphoma - results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group (GLSG)

In advanced follicular lymphoma conventional chemotherapy has failed to substantially prolong survival. To improve the outcome, the German Low-Grade Lymphoma Study Group (GLSG) initiated a randomized trial, comparing the effect of a potentially curative myeloablative radiochemotherapy followed by autologous stem cell transplantation (ASCT) to α-interferon maintenance (IFNα) in first remission. 307 patients (younger than 60 years) with follicular lymphoma from 130 institutions were recruited into this trial. After two cycles of a CHOP-like induction chemotherapy, patients were randomly assigned to either ASCT or IFNα. The respective therapy was started when patients achieved a complete or partial remission after induction chemotherapy. 240 patients with follicular lymphoma are evaluable for the comparison of ASCT vs. IFNα. In patients receiving ASCT, the five-year progressionfree survival (PFS) was 64.7% as compared to 33.3% in the IFNα arm (p < 0.0001). As expected, acute toxicity was higher in the ASCT group, however early mortality was below 2.5% in both study arms. In this randomized multicenter trial, high-dose radiochemotherapy followed by ASCT significantly improved the PFS in comparison to IFNα in patients with follicular lymphoma when applied as consolidation in first remission. Longer follow-up is necessary to determine the effect of ASCT on the overall survival. For personal use only. on September 24, 2017. by guest www.bloodjournal.org From