PROGNOSTIC FACTORS FOR SURVIVAL OF NON-HODGKINS-LYMPHOMA PATIENTS TREATED WITH HIGH-DOSE CHEMOTHERAPY AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION

Prognostic factors to identify patients with high-risk non-Hodgkin's l ymphoma (NHL) have recently been developed. We retrospectively investi gated the relation between prognostic factors and treatment outcome af ter autologous bone marrow transplantation (ABMT). From 1984 to 1994, 80 consecutive patients with NHL responding slowly to or relapsing aft er front-line therapy were treated with high-dose chemotherapy and ABM T. Prognostic factors at the time of diagnosis and of ABMT were relate d to clinical outcome after ABMT. The cumulative 5-year overall surviv al (OS) was 51%, progression-free survival (PFS) 41%, and relapse-free survival (RFS) 53%. Absence of B symptoms and intermediate-grade mali gnancy at first presentation of disease were independently related to prolonged OS (P = 0.02 and P < 0.01, respectively) and prolonged PFS ( P = 0.005 and P = 0.01, respectively). At the time of ABMT, first PR o r CR, normal LDH levels and tumour stage I + II were associated with p rolonged OS (P = 0.0005, P = 0.03 and P = 0.004, respectively). A Coif fier index of 0 or 1, first PR or CR and no extranodal disease involve ment were related to prolonged PFS (P = 0.0002, P = 0.005 and P = 0.07 , respectively). Treatment-related deaths occurred in 10% of patients. Assessment of disease status, LDH level, tumour stage, extranodal dis ease involvement and Coiffier index at the time of ABMT is relatively efficient in predicting treatment outcome after ABMT.