Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Department of Transfusion and Cell Therapy, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
J Clin Exp Hematop. 2024 Sep 28;64(3):177-182. doi: 10.3960/jslrt.24011. Epub 2024 Jul 31.
High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HDC/ASCT) has been useful in relapsed or refractory classic Hodgkin lymphoma (RRcHL). Furthermore, a ranimustine, cytarabine, etoposide, and cyclophosphamide (MCVAC) conditioning regimen has been effective in diffuse large B-cell lymphoma. However, limited data are available regarding this conditioning regimen for cHL. In this study, we investigated the efficacy and toxicity of MCVAC for RRcHL. We retrospectively analyzed 10 patients with RRcHL who underwent ASCT preceded by the MCVAC conditioning regimen between January 2009 and December 2021 at our institution. A total of 10 patients (median [range] age, 36 [23-64] years), including 5 (50%) men and 5 (50%) women, were treated with the MCVAC regimen followed by ASCT. The median follow-up duration of the 10 patients was 25.0 months. The 36-month PFS and OS rates were 43.8% (95% CI, 11.9%-72.6%) and 64.0% (95% CI, 22.6%-87.5%), respectively. Two patients died because of treatment-related factors, and one patient died because of disease progression. Based on our findings, recognizing the risk factors for adverse events (AEs) associated with this treatment, MCVAC may be a valid treatment option for the management of RRcHL.
大剂量化疗后自体造血干细胞移植(HDC/ASCT)已在复发或难治性经典霍奇金淋巴瘤(RRcHL)中得到应用。此外,雷米司亭、阿糖胞苷、依托泊苷和环磷酰胺(MCVAC)预处理方案在弥漫性大 B 细胞淋巴瘤中也很有效。然而,关于该预处理方案在 cHL 中的应用数据有限。本研究旨在探讨 MCVAC 方案在 RRcHL 中的疗效和毒性。我们回顾性分析了 2009 年 1 月至 2021 年 12 月期间在我院接受 ASCT 前接受 MCVAC 预处理方案治疗的 10 例 RRcHL 患者。共 10 例患者(中位[范围]年龄 36[23-64]岁),包括 5 例(50%)男性和 5 例(50%)女性,接受 MCVAC 方案治疗后进行 ASCT。10 例患者的中位随访时间为 25.0 个月。36 个月的 PFS 和 OS 率分别为 43.8%(95%CI,11.9%-72.6%)和 64.0%(95%CI,22.6%-87.5%)。2 例患者因治疗相关因素死亡,1 例患者因疾病进展死亡。根据我们的研究结果,鉴于与该治疗相关的不良事件(AE)的危险因素,MCVAC 可能是 RRcHL 治疗的有效选择。