We have previously reported the results of 3 cycles R-CHOP, one cycle ARA-C and autologous stem cell transplantation (AST) in newly diagnosed patients (Br J Haematol 2008, van ��t Veer et al). To improve these results, we added a second ARA-C cycle in the induction phase. Following transplantation patients were randomized between bortezomib maintenance or no treatment. Here, we report the results of the induction phase. Methods: Patients 18-65 years with newly diagnosed MCL were treated with 3 cycles of R-CHOP and 2 cycles of ARA-C (2 x 2 g/m2 iv d1-4) and rituximab (375 mg/m,2 iv d11). Patients in PR or CR continued with AST after BEAM conditioning. Response was evaluated after the second cycle of selleck chemicals llc
ARA-C and after AST. Results: Between October 2007 and February 2012 140 patients aged 34-66 (median 57) years were registered. Five patients were not eligible. The MIPI score was low, intermediate, high or unknown in 56%, 32%, 9% and 3% respectively. Hundred-thirty-two patients continued with ARA-C. Six patients did not receive the second cycle of ARA-C, because of excessive toxicity (n=3), progressive disease (PD) (n=1), or other reasons (n=2). 111/132 patients (84%) proceeded to AST. selleck chemical
Reasons not to proceed were inadequate stem cell harvest (n=4), PD (n=4), other reasons (n=3) or unknown (n=4). ARA-C was complicated by infections grade 3/4 in 48%/1% (cycle 1) and 32%/1% (cycle 2) of patients. Other gr 3/4 side effects were observed in <5% of the patients. No toxic deaths were observed. The response after ARA-C was CR/CRu in 76 patients (59%), PR in 37 (28%), SD in 3, PD in 2 and unknown in 12 patients. After AST 96 patients (74%) had a CR/CRu, 13 (10%) a PR, and from 21 (16%) response is still unknown. This response rate compares favorably to the previous study with one cycle of ARA-C, in which after AST CR and PR were 60% and 7% respectively. Conclusion: The toxicity of the second cycle ARA-C is acceptable and not increased compared to the <a href="http://www.selleck.cn/products/Erlotinib-Hydrochloride.html
">Erlotini first cycle. This study showed that the regimen with a second cycle of ARA-C results in a higher CR/CRu rate, compared to the outcome with one cycle of ARA-C. This confirms the important role of ARA-C in the treatment of MCL. 416 HIGH-DOSE ARA-C OR GEMCITABINE-OXALIPLATIN INDUCTION, AUTO-SCT AND R-MAINTENANCE HAS CHANGED EVENT FREE SURVIVAL AND OVERALL SURVIVAL IN MANTLE CELL LYMPHOMA PATIENTS. V. Vorobyev,1 S. Kravchenko,2 E. Gemdjan,2 Y. Lorie,2 J. Mangasarova,2 A. Magomedova,2 N. Turina,3 E. Dubrovin,2 A. Melikyan,1 V. Savchenko.1 1High Dose Chemotherapy and Intensive Care, National Research Center for Hematology, Moscow, Russian Federation, 2High Dose Chemotherapy and Intensive Care, National Research Center for Hematology, Moscow, Russian Federation, 3High Dose Chemotherapy, P.A.