HIGH-DOSE THERAPY FOLLOWED BY BONE-MARROW TRANSPLANTATION FOR RELAPSED FOLLICULAR NON-HODGKINS-LYMPHOMA

Purpose: To analyze whether, in addition to survival, and disease-free survival progression-free interval after transplantation would be lon ger than the last progression-free interval before transplantation, su pporting the argument that high-dose therapy may change the biologic b ehavior of the disease. Patients and Methods: Patients with a poor-ris k relapsed follicular NHL were treated with three cycles of doxorubici n 50 mg/m(2) and teniposide 60 mg/m(2), followed by etoposide 350 mg/m (2), cyclophosphamide 60 mg/kg, and TBI and unpurged BMT. Results: Twe lve patients were entered in the study. Ten patients fulfilled the cri teria for response and underwent transplantation, two of them with an allograft. Nine of ten patients with transplants achieved a complete r emission after BMT. One patient died on day 41 due to veno-occlusive d isease. The nine patients with transplants who were evaluable for foll ow-up had a conversion of remission or response duration after transpl antation, their progression-free interval after BMT being superior to the last one before BMT with a median of 1044+ days. Overall survival and disease-free survival in the transplant patients after a median fo llow-up of 1160 days from BMT is 90%. Conclusion: High dose chemothera py followed by stem cell rescue may change the clinical course in foll icular non-Hodgkin's lymphoma patients.