PROLONGED DISEASE-FREE SURVIVAL AFTER ABLATIVE CHEMORADIOTHERAPY AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN ADULT MALIGNANT-LYMPHOMA

From June 1983 to December 1991, 21 adult patients with intermediate o r high-grade malignant lymphoma (ML) were treated by ablative chemorad iotherapy, including vincristine, cytosine arabinoside, BCNU and cyclo phosphamide plus total lymphoid or body irradiation with boost irradia tion over bulky and original tumor areas [Hd-VCCA+TL(B) I] together wi th autologous bone marrow transplantation (ABMT). Five patients were i n advanced stage, 2 in drug-resistant relapse, 6 in drug sensitive rel apse, 6 in first complete remission (CRI) and 2 in CR2. One with marro w involvement at ABMT. The 8-year disease-free survival after ABMT in patients with Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) in 89% and 63%, respectively, with a median follow-up up to 34 months. This study demonstrated that our Hd-VCCA+TL(B) I regimen and ABMT per formed early in CR or drug-sensitive relapse of adult poor prognosis l ymphoma, may potentially cure more than 70% of them. The toxicity of t he present treatment is tolerable. The results confirm the value of AB MT in the treatment of adult ML, and suggest that it is necessary to p urge the residual tumor cells in the bone marrow at ABMT in patients w ith marrow infiltration, or lymphoblastic lymphoma.