AUTOLOGOUS BONE-MARROW TRANSPLANTATION AS CONSOLIDATION THERAPY MAY PROLONG REMISSION IN NEWLY-DIAGNOSED HIGH-RISK FOLLICULAR LYMPHOMA - A PILOT-STUDY OF 34 CASES

We evaluated early intensification followed by autologous bone marrow transplantation (ABMT) using marrow purged by mafosfamide in patients with high-risk low-grade follicular lymphoma (LGFL) reaching a status of minimal disease (MD). Thirty-four patients entered the program. All fulfilled at least one of the following criteria at diagnosis: a bulk y tumor >7 cm; three or more adenopathies >3 cm; massive pleural or pe ritoneal effusion; massive splenomegaly; B symptoms; platelet count <1 00 x 10(9)/l. Twenty-one patients had bone marrow involvement. Twenty- six patients received ACVBP, and eight CVP as front-line therapy. Twen ty-one (62%) patients achieved MD status, 18 reached intensification. At 4 years, the time to treatment failure is 55+/-9%, and the probabil ity of persisting remission is 75+11%. Comparison by intention to trea t of the 26 patients who received ACVBP as front-line therapy to 14 hi storical high-risk LGFL similarly treated in our institution without i ntensification, showed better results for the intensified group (P = 0 .04 for both probability of persisting remission and time to treatment failure). These results indicate that early intensification using mar row purged with mafosfamide is a therapeutic option which may bring be nefit to patients with high-risk LGFL.