Primary treatment with autologous stem cell transplantation in XXXX : outcome related to remission pretransplant.

@entity1 @entity3726 @entity5 @entity1073
OBJECTIVES: The aim of the first @entity1073 ( @entity1073 ) protocol was to study the clinical significance of an augmented @entity3726 induction chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) and to examine the prognostic significance of stem cell contamination rates in newly diagnosed @entity1 with @entity1073 . @entity1 AND METHODS: Forty-one newly diagnosed @entity1 below 66 yr were enrolled and given three series of an augmented @entity3726 regimen. Responders underwent stem cell mobilization with a fourth course of @entity3726 , stem cell harvest and ASCT. Stem cell purging was optional in the protocol and followed the routine of each participating centre. The number of @entity5 cells in the reinfused autografts was estimated by flow cytometry or quantitative PCR. RESULTS: Induction therapy led to complete remission (CR) in 11 of 41 @entity1 (27%), partial remission (PR) in 20 of 41 @entity1 (49%) and no response in nine @entity1 (22%), whereas one @entity1 was not evaluable. Twenty-seven of the 31 responders underwent ASCT and 24 achieved or maintained a CR. The overall and failure-free 4-yr survival on intention-to-treat basis were 51% and 15%, respectively. Among the transplanted @entity1 , a significantly increased failure-free (P<0.03) and overall survival (P=0.03) was noted among @entity1 transplanted in CR compared with PR, respectively. By contrast, reinfusion of highly variable numbers of @entity5 cells with the autografts (range 0.71-80 x 10(6) @entity5 cells), did not affect outcome. CONCLUSION: In @entity1073 , an important strategy to improve the outcome will be to intensify the induction chemotherapy.
