12th Congress of the European Hematology ... - Haematologica

known at NHL diagnosis, were included in the study. Co-infected and
mono-infected patients were treated with the same therapeutical protocols.
Results. 301 HIV patients with NHL were included in the study: 123
(40.2%) HCV co-infected and 178 mono-infected. As regards HIV disease’s
characteristics, co-infected patients had a significant higher percentage
of intravenous drug users (IDU) in comparison with monoinfected
patients, whereas no significant differences were seen in CD4
and CD8 count, HIV viral load, AIDS defining condition at NHL diagnosis
and antiretroviral therapy. As regards NHL’s characteristics at the
onset, co-infected patients showed a significant lower percentage of
Burkitt histotype, whereas no significant differences were seen in Performance
Status, stage, International Prognostic Index. Co-infected
patients showed a significantly higher NHL involvement of the spleen.
No differences were observed in response rate (RR), complete response
rate (CRR) and overall survival (OS) at 5 years. Co-infected patients had
a significantly higher percentage of G3-G4 liver toxicity during
chemotherapy (4.5% vs 0%; p=0.0083) although it was not life threatening.
Conclusions. Co-infected patients had a higher rate of IDU, Burkitt
histotype and NHL spleen involvement; no other differences were
observed in the characteristics of HIV and NHL disease. No differences
in RR CRR and OS were observed between co- and mono-infected
patients, although a higher rate of liver toxicity was observed in coinfected
patients.
0727
COMPARISON OF STANDARD CHOP TREATMENT WITH SHORT- INTENSIVE SPECIFIC
CHEMOTHERAPY IN AIDS-RELATED BURKITTS LYMPHOMA OR LEUKEMIA (BL/ALL3)
B. Xicoy, 1 J.M. Ribera, 1 J. Berenguer, 2 J. la Cruz, 2 A. Oriol, 1
E. Valencia, 2 M. Morgades, 1 B. Mahillo, 2 E. del Potro, 3 M.J. Tellez, 2
S. Brunet, 3 J. Esteve3 1 Institut Català D'Oncologia-HGTiP, BADALONA; 2 GESIDA Group,
MADRID; 3 PETHEMA Group, BARCELONA, Spain
Background and Objective. The results of CHOP therapy for AIDS-related
BL/ALL3 are poor. Specific intensive multiagent chemotherapy schedules
have been also used, but there are scarce studies comparing their
results with those of CHOP-based regimens. This retrospective study
aimed to compare 31 patients (pts) with AIDS-related BL/ALL3 treated
with CHOP±rituximab with 33 pts treated with two consecutive specific
protocols (PETHEMA-LAL3/97 and PETHEMA-LAL3/LB-04). Design
and Methods. Pts from Group A (n=31) received 6 standard CHOP cycles
every 3 weeks±rituximab. Protocols from group B included a pre-phase
with CPM and PDN followed by six cycles including HD-MTX and HD-
ARA-C. Rituximab was added to each block of chemotherapy in the
PETHEMA-LAL3/LB-04 trial. Since 1996, HAART was given to all pts
from diagnosis if it was not already being received. Response to
chemotherapy, OS and EFS were compared. Results. Both groups were
comparable for the main clinical and biological parameters at diagnosis,
exept for ECOG score (0-2 in 61% pts from Group A vs 85% pts from
group B, p=0.03), B symptoms (61% vs 85%, p=0.04) and number of
extranodal sites involved (≥3 0% vs 18%, p=0.01). Group A: CHOP
(n=29) and R-CHOP (n=2). Group B: PETHEMA-LAL3/97 trial (n=19)
and PETHEMA-LAL3/LB-04 trial (n=14). Median age was 38 (25-58) yr.
in grup A and 40 (23-65) yr. in group B, being males 22 (71%) and 28
(85%), in each group, respectively. 16 pts (51%) in group A and 11 pts
(33%) in group B were in leukemic phase. CD4 lymphocyte count at
diagnosis was over 200/mL in 42% and 55% of pts and HAART was
administered in 60% and 73% of evaluable pts in each group, respectively.
CR was achieved in 10 out of 31 (32%) pts in group A and 22 out of
33 (67%) pts in group B (p=0.006). Resistance was more frequent in
group A (15/21) than in group B (4/11) (p=0.06). 3-year (95% CI) EFS was
32% (15-49%) for group A and 50% [30%-70%] for group B (p=0.1), and
3-year (95% CI) OS was 32% (15-49%) for Group A and 49% (29-69%)
(p=0.097) for group B. Conclusions. Short-intensive specific chemotherapy
in AIDS-related BL/L3ALL is feasible, with higher remission rate than
that obtained with CHOP-based regimes. A trend for an improved survival
is observed in pts receiving short-intensive specific chemotherapies.
Supported in part by grant P-EF/06 from José Carreras Leukemia Fundation
and 021210 from Fundació La Marató de TV3.
12 th Congress of the European Hematology Association
0728
LONG REMISSION ARE POSSIBLE AFTER NON MYELOABLATIVE TRANSPLANT IN
PATIENTS WITH FOLLICULAR NON-HODGKINS LYMPHOMA: RESULTS OF TWO
PROSPECTIVES MULTICENTER TRIALS
M.-V.M. Mateos, 1 M.D. Caballero, 1 R. Martino, 2 M.V. Mateos, 1
J. Briones, 2 J. De la Serna, 3 J.F. Tomas, 4 R. Arranz, 5 J.L. Díez, 6 V. Rubio, 7
J.M. Ribera, 8 J.M. Moraleda, 9 G. Sanz, 10 A. Urbano, 11 J. Sarrá, 12
A. Sampol, 13 J. Sierra2 1 University Hospital of Salamanca, SALAMANCA; 2 Hospital Santa Creu i
Sant Pau, BARCELONA; 3 Hospital 12 de Octubre, MADRID; 4 MD Anderson,
MADRID; 5 Hospital La Princesa, MADRID; 6 Hospital Gregorio Marañón,
MADRID; 7 Hospital del SAS, JEREZ DE LA FRONTERA CADIZ; 8 Hospital
Germans Trials i Pujol, BARCELONA; 9 Hospital Morales Messeguer, MUR-
CIA; 10 Hospital La Fe, VALENCIA; 11 Hospital Clinic i Provincial,
BARCELONA; 12 Institut Catalá d'Oncologia, L'HOSPITALET DE LLOBRE-
GAT; 13 Hospital SonDureta, PALMA DE MALLORCA, Spain
Myeloablative transplant has been investigated in poor prognosis
indolent lymphoma; although recurrence rate is low it is associated with
high mortality; the use of non-myeloablative conditioning regimens
could reduce TRM maintaining the GVH effect. Up to May 2006, 35
patients with follicular NHL received a Non Myeloablative related allogeneic
according to two prospective multicenter trials; conditioning regimen
consisted of Fludarabine 150 mg and Melphalan 70-140 mg. GVHD
prophylaxis consisted of CSA plus short-course MTX. All patients
received filgrastim-stimulated peripheral blood stem cells from a HLA
related identical donor. Median age at transplant was 50 years (34-62)
and 16 (46%) had received a previous autologous transplant. At transplant,
5 patients (14%) were in CR1 (after several lines of chemotherapy),
9 (25%) in >CR1, 12 (34%) in PR, 1 (3%) had stable disease (after 3
chemotherapy lines) and 8 (23%) progressive disease. All patients
engrafted. Acute GVHD developed in patients 19 (54%) (17patients
(48%) grade II'IV). Chronic GVHD developed in 18 out of 27 patients at
risk (67%), being extensive in 11 (41%). Disease was evaluated at day
+100 and at that moment 23 patients were in CR, (85%) 1 (4%) in PR,
two (7%) had stable disease and 9 patients (26%) have died. With a
median follow up of 60 months (range: 32-80 months), 20 patients (57%)
are alive disease free, and 14 (43%) have died, 12 of them (37%) due to
transplant toxicity and 2 patients (6%) due to progression. Overall Survival
(OS) and Event Free Survival (EFS) are 57 and 54% respectively.
Analysing variables which influence on OS and EFS, patients 55 years
have a OS significantly shorter than those