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Conference Paper: Oral arsenic trioxide based regimen as salvage treatment for relapsed or refractory mantle cell lymphoma

TitleOral arsenic trioxide based regimen as salvage treatment for relapsed or refractory mantle cell lymphoma
Authors
Issue Date2013
PublisherAmerican Society of Hematology. The Journal's web site is located at http://bloodjournal.hematologylibrary.org/
Citation
The 55th Annual Meeting and Exposition of the American Society of Hematology (ASH 2013), New Orleans, LA., 7-10 December 2013. In Blood, 2013, v. 122 n. 21 How to Cite?
AbstractMantle cell lymphoma (MCL) is an aggressive B-cell lymphoproliferative disorder, and relapsed/refractory disease has a poor prognosis. In patients with relapsed / refractory MCL, optimal treatment strategy remains undefined. Oral arsenic trioxide (As2O3) was initially developed for the treatment of relapsed acute promyelocytic leukemia (APL). As2O3 inhibits neoplastic cellular proliferation by a wide array of mechanisms, including induction of apoptosis, targeting of signaling pathways, and down-regulation of BCL-2. Evidence in vitro also suggested that As2O3 might be effective in lymphoma, but clinical data are hitherto not available. In this study, we investigated the use of an oral-As2O3-based regimen for the treatment of patients with relapsed / refractory MCL. Thirty-nine patients (men=34, women=5) at 64 (41–82) years of age with relapsed/refractory MCL, who had received 2 (1–5) prior regimens and were ineligible for high-dose chemotherapy, were treated with a continuous oral regimen, comprising oral arsenic trioxide (oral-As2O3), chlorambucil and ascorbic acid. The overall response rate was 49% (complete response: 28%; partial response: 21%). Only grade 1/2 toxicities were observed (hematologic: 56%, hepatic: 8%). Independent prognostic factors for response were increased lactate dehydrogenase (P=0.04) and unfavorable MCL international prognostic index (P=0.04). At a median follow up of 21(range:1-118) months, the median progression-free-survival (PFS) was 16 months, and overall-survival (OS) 38 months. The 2-year and 5-year PFS were 41% and 29% respectively. The 2-year and 5-year OS were 56% and 43% respectively. Independent prognostic factors for PFS were female gender (P=0.002), Eastern Cooperative Oncology Group (ECOG) performance score of 2 (P=0.009), and non-response to treatment (P<0.001). Independent prognostic factors for OS were female gender (P<0.001), ECOG performance score of 2 (P=0.03), non-response to treatment (P<0.001), and disease progression while on treatment (P=0.05). These findings showed that an oral regimen of oral-As2O3, chlorambucil and ascorbic acid was an active regimen with minimal toxicity in relapsed/refractory MCL, achieving durable responses in some cases. © 2013 by The American Society of Hematology
DescriptionThis journal issue contain 2013 ASH Annual Meeting Abstracts
Persistent Identifierhttp://hdl.handle.net/10722/207344
ISSN
2015 Impact Factor: 11.841
2015 SCImago Journal Rankings: 6.395

 

DC FieldValueLanguage
dc.contributor.authorGill, Hen_US
dc.contributor.authorAu, WYen_US
dc.contributor.authorCheung, WWWen_US
dc.contributor.authorKwong, YLen_US
dc.date.accessioned2014-12-19T10:54:28Z-
dc.date.available2014-12-19T10:54:28Z-
dc.date.issued2013en_US
dc.identifier.citationThe 55th Annual Meeting and Exposition of the American Society of Hematology (ASH 2013), New Orleans, LA., 7-10 December 2013. In Blood, 2013, v. 122 n. 21en_US
dc.identifier.issn0006-4971-
dc.identifier.urihttp://hdl.handle.net/10722/207344-
dc.descriptionThis journal issue contain 2013 ASH Annual Meeting Abstracts-
dc.description.abstractMantle cell lymphoma (MCL) is an aggressive B-cell lymphoproliferative disorder, and relapsed/refractory disease has a poor prognosis. In patients with relapsed / refractory MCL, optimal treatment strategy remains undefined. Oral arsenic trioxide (As2O3) was initially developed for the treatment of relapsed acute promyelocytic leukemia (APL). As2O3 inhibits neoplastic cellular proliferation by a wide array of mechanisms, including induction of apoptosis, targeting of signaling pathways, and down-regulation of BCL-2. Evidence in vitro also suggested that As2O3 might be effective in lymphoma, but clinical data are hitherto not available. In this study, we investigated the use of an oral-As2O3-based regimen for the treatment of patients with relapsed / refractory MCL. Thirty-nine patients (men=34, women=5) at 64 (41–82) years of age with relapsed/refractory MCL, who had received 2 (1–5) prior regimens and were ineligible for high-dose chemotherapy, were treated with a continuous oral regimen, comprising oral arsenic trioxide (oral-As2O3), chlorambucil and ascorbic acid. The overall response rate was 49% (complete response: 28%; partial response: 21%). Only grade 1/2 toxicities were observed (hematologic: 56%, hepatic: 8%). Independent prognostic factors for response were increased lactate dehydrogenase (P=0.04) and unfavorable MCL international prognostic index (P=0.04). At a median follow up of 21(range:1-118) months, the median progression-free-survival (PFS) was 16 months, and overall-survival (OS) 38 months. The 2-year and 5-year PFS were 41% and 29% respectively. The 2-year and 5-year OS were 56% and 43% respectively. Independent prognostic factors for PFS were female gender (P=0.002), Eastern Cooperative Oncology Group (ECOG) performance score of 2 (P=0.009), and non-response to treatment (P<0.001). Independent prognostic factors for OS were female gender (P<0.001), ECOG performance score of 2 (P=0.03), non-response to treatment (P<0.001), and disease progression while on treatment (P=0.05). These findings showed that an oral regimen of oral-As2O3, chlorambucil and ascorbic acid was an active regimen with minimal toxicity in relapsed/refractory MCL, achieving durable responses in some cases. © 2013 by The American Society of Hematology-
dc.languageengen_US
dc.publisherAmerican Society of Hematology. The Journal's web site is located at http://bloodjournal.hematologylibrary.org/en_US
dc.relation.ispartofBlooden_US
dc.rightsThis research was originally published in The Hematologist: ASH News and Reports. Author(s). Title. The Hematologist: ASH News and Reports. Year;Vol,Issue:pp-pp. © the American Society of Hematology.-
dc.titleOral arsenic trioxide based regimen as salvage treatment for relapsed or refractory mantle cell lymphomaen_US
dc.typeConference_Paperen_US
dc.identifier.emailKwong, YL: ylkwong@hku.hken_US
dc.identifier.authorityKwong, YL=rp00358en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros241799en_US
dc.identifier.volume122en_US
dc.identifier.issue21en_US
dc.publisher.placeUnited States-

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