THE USE OF CONVENTIONAL SALVAGE CHEMOTHERAPY BEFORE DOSE-INTENSIVE CYTOTOXIC THERAPY AND AUTOLOGOUS TRANSPLANTATION FOR AGGRESSIVE-HISTOLOGY LYMPHOMA - A CASE FOR REEVALUATION

The use of CSCT to judge suitability for DIT and AHSCT in patients wit h aggressive-histology lymphoma who recur after primary chemotherapy i s a widespread practice that excludes many NHL patients from this pote ntially curative therapy. Surprisingly, little direct evidence exists to suggest that CSCT used in this way is a useful strategy. On the oth er hand, it is clear that many of these patients undergoing DIT and AH SCT will not be cured using any currently available strategy or techni que, and a method to identify such patients would be most helpful. CSC T may or may not be the best way to do so. This is an important questi on, but currently there are insufficient data to give us a definitive answer. clinical trials are needed to resolve the issue. If the utilit y of CSCT is not validated, it should be abandoned. If it is validated , however, we may begin to address ways in which CSCT may be given mor e effectively.