AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN THE TREATMENT OF CUTANEOUS LYMPHOMA

Introduction. The prognosis of advanced stage or high grade cutaneous lymphomas is very poor in case of recurrence after conventional polych emotherapy. Recent studies have confirmed the importance of intensifie d treatment with autologous bone marrow transplantation in case of rec urrence. We used this method in patients with a cutaneous lymphoma wit h poor prognosis. Patients and methods. Seven patients with a high-gra de or disseminated cutaneous lymphoma were given an autologous bone ma rrow graft in case of recurrence after one or more polychemotherapy pr otocols. In 4 patients, treatment included total body irradiation and high-dose chemotherapy (cyclophosphamide/etoposide, or aracytine/melph alan) and in the 3 others chemotherapy alone (BEAM or BEAC) was used p rior to transplantation. Results. Two complete remissions of 46 and 34 months duration after graft were achieved without complementary treat ment. One patient had partial remission. Recurrence was observed in 2 patients 5 months after the graft and in 1 other 30 months later. Prol onged complete remission was observed in patients given total body irr adiation and the early recurrences in those given chemotherapy alone. Discussion. This pilot study demonstrates that patients with a poor pr ognosis cutaneous lymphoma can achieve prolonged complete remission by therapy intensification using autologous bone marrow transplantation after total body irradiation.