Efficiency of the HyperCVAD regimen with or without high-dose therapy combined with autologous hematopoietic stem cell transplantation in lymphoblastic lymphoma

Objectives: This study evaluated the efficiency of HyperCVAD regimen with or without high-dose therapy (HDT) combined with autologous hematopoietic stem cell transplantation (AHSCT) in lymphoblastic lymphoma (LL). Methods: Data of 26 adolescent and adult LL patients were retrospectively analyzed. These patients were initially treated with the modified HyperCVAD regimen in a basic institution. Except 4 of the total 26 patients who suffered bone-marrow involvements, 11 patients received consolidation treatment of HDT/AHSCT, and the other 11 did not. Results: Of the total patients, 61.5% achieved complete remission (CR) or unconfirmed CR. With a median follow-up period of 29.5 months, the 5-year overall survival (OS) and progress-free survival (PFS) rates were 66.8% and 50.2%, respectively. Of the 22 patients without bone marrow involvement, the corresponding 5-year OS rates were 60.0% and 70.7% in the patients treated with the HyperCVAD regimen alone and in those who received HDT/AHSCT as consolidation therapy (P=0.438), with 5-year PFS rates of 43.6% and 62.3%, respectively (P=0.209). Disease progression or relapse within a year was identified as the only significant prognostic factor for OS in univariate analysis. Conclusion: The HyperCVAD regimen is an effective initial therapy for adolescent and adult LL patients. For patients without bone marrow involvement, the HyperCVAD regimen combined with HDT/AHSCT is not superior over the HyperCVAD regimen alone.