Table 2.
Randomized controlled trials with consolidative, frontline autologous hematopoietic stem-cell transplantation (ASCT) in patients with follicular lymphoma.
| Reference | n | Induction regimen | Response prior to ASCT | Randomized to ASCT receiving ASCT (%) | Comparison chemotherapy | Median follow up (months) | Overall survival | Event/failure/progression/disease-free survival | Risk stratification |
|---|---|---|---|---|---|---|---|---|---|
| Lenz et al. [2004] | 240 | 4–6 cycles CHOP, DEXA-BEAM/CY-TBI | CR/PR | 100 | 8 cycles CHOP, then interferon | 50 | Not reported | 5 years, 65% with ASCT versus 33% control (p < 0.0001) | IPI ASCT: 7% intermediate–high risk; control: 9% intermediate–high risk |
| Sebban et al. [2006] | 401 | 4 cycles CHOP, then high-dose cyclophosphamide and etoposide, cyclophosphamide, mesna, and etoposide | CR/PR | 87 | 6 cycles of cyclophosphamide, doxorubicin, teniposide, prednisone, and interferon | 92 | 7 years, 76% with ASCT versus 71% control | 7 years, EFS 38% with ASCT versus 28% control (p = 0.11) | FLIP IASCT: 43% intermediate–risk, 27% high risk; control: 34% intermediate–risk, 34% high risk |
| Ladetto et al. [2008] | 134 | 2 cycles doxorubicin, vincristine, prednisone and etoposide, cyclophosphamide, rituximab, then mitoxantrone, melphalan | CR/PR | 79 | 6 cycles CHOP, then rituximab | 51 | 4 years, 81% with ASCT versus 80% control | 4 years, PFS 68% with ASCT versus 31% control (p < 0.001) | FLIP IASCT: 65% high risk; control: 51% high risk |
| Gyan et al. [2009] | 166 | 2–3 cycles of cyclophosphamide, high-dose doxorubicin, prednisone, vincristine, then ifosfamide, methotrexate, VP-16 and cyclophosphamide | CR/PR | 90 | 6-cycle induction cyclophosphamide, doxorubicin, teniposide, prednisone, then 2-year maintenance interferon | 108 | 9 years, 76% with ASCT versus 80% control (p = NS) | 9 years, PFS 64% with ASCT versus 39% control (p = 0.004) | FLIP IASCT: 47% intermediate risk, 23% high risk; control: 39% intermediate risk, 33% high risk |
CHOP, cyclophosphamide, doxorubicin, vincristine, prednisone; CR, complete response; Cy/TBI, cyclophosphamide/total body irradiation; DEXA-BEAM, dexamethasone, carmustine, etoposide, cytarabine, melphalan; EFS, event-free survival; FLIPI, follicular lymphoma international prognostic index; IPI, international prognostic index; NS, nonsignificant; PFS, progression-free survival; PR, partial response.