Safety and feasibility of high-dose ranimustine (MCNU), carboplatin, etoposide, and cyclophosphamide (MCVC) therapy followed by autologous stem cell transplantation for malignant lymphoma

Yoshihi Kameoka, Naoto Takahashi, Kenichi Ishizawa, Yuichi Kato, Jugo Ito, Osamu Sasaki, Kazunor Murai, Hideyos Noji, Makoto Hirokawa, Katsusi Tajima, Tsutomu Shichishima, Yoji Ishida, Hideo Harigae, Kenichi Sawada

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

High-dose chemotherapy followed by autologous stem cell transplantation (auto-SCT) is widely used as a salvage therapy in the treatment of refractory malignant lymphoma. To investigate the safety and feasibility of a high-dose MCNU, carboplatin, etoposide and cyclophosphamide (MCVC) regimen, we conducted a prospective multicenter trial. Thirty patients with relapsed/refractory/ poor-risk non-Hodgkin lymphoma (NHL n = 27) or Hodgkin lymphoma (HD n = 3) were uniformly treated with an MCVC regimen and underwent auto-SCT. The median follow-up duration of the surviving patients was 67 months (56-133 months). The major toxicities were anorexia (94 %), diarrhea (80 %), nausea (79 %), febrile neutropenia (70 %), alopecia (67 %) and mucositis (60 %). Three patients developed severe left ventricular dysfunction, and two patients developed severe sinusoidal obstructive syndrome (SOS). Of these patients, two died without disease progression. Treatment-related mortality was 6.6 %. Late-onset adverse events including two cases of cytomegalovirus pneumonia and one of interstitial pneumonia were observed. In DLBCL (n = 13) and transformed FL (n = 2) patients, OS and EFS at 3 years were 72 and 46 %, respectively. These results suggest that the MCVC regimen followed by auto-SCT is a feasible and tolerable therapy for relapsed/refractory malignant lymphoma. However, cardiac toxicity due to high-dose cyclophosphamide and development of SOS can occur and should be carefully monitored. Further follow-up is needed to evaluate the long-term efficacy and safety of this regimen.

Original languageEnglish
Pages (from-to)624-630
Number of pages7
JournalInternational journal of hematology
Volume96
Issue number5
DOIs
Publication statusPublished - 2012 Nov

Keywords

  • Auto-SCT
  • Feasibility
  • MCVC
  • Malignant lymphoma
  • Safety

ASJC Scopus subject areas

  • Hematology

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