HIGH-DOSE THERAPY AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN PATIENTS WITH FOLLICULAR LYMPHOMA DURING FIRST REMISSION

We report the results of a study in previously untreated advanced stag e patients with follicular lymphoma (FL) who underwent uniform inducti on chemotherapy with cyclophosphamide, doxorubicin, vincristine, predn isone (CHOP) followed by myeloablative therapy and anti-B-cell monoclo nal antibody purged autologous bone marrow transplantation (ABMT). Eig hty-three patients with previously untreated, low-grade FL were enroll ed. After CHOP induction, only 36% achieved complete remission (CR) an d 77 patients underwent ABMT, Before BM harvest, 70 patients had a kno wn t(14;18), as determined by polymerase chain reaction (PCR), and all remained PCR positive in the BM at harvest, After ABMT, the disease-f ree survival (DFS) and overall survival are estimated to be 63% and 89 % at 3 years, respectively, with a median follow-up of 45 months, Pati ents whose BM was PCR negative after purging experienced significantly longer freedom from recurrence (FFR) than those whose BM remained PCR positive (P = .0006), Continued PCR negativity in follow-up BM sample s was also strongly predictive of continued CR, This study suggests th at a subset of patients with advanced FL may experience prolonged clin ical and molecular remissions following high-dose ablative therapy, al though longer follow up will be necessary to determine potential impac t on overall survival. (C) 1996 by The American Society of Hematology.