HIGH-DOSE THERAPY AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN 1ST COMPLETE REMISSION FOR ADULT PATIENTS WITH HIGH-GRADE NON-HODGKINS-LYMPHOMA - THE EBMT EXPERIENCE

One hundred and eighteen patients presenting with high-grade non-Hodgk in's lymphoma, undergoing autologous bone marrow transplantation (ABMT ) in first complete remission (CR), have been reported to the European Group for Bone Marrow Transplantation (EBMT). Of these, 102 were elig ible for inclusion in this study following review of registration form s. Patients with lymphoblastic lymphoma were excluded. Remission induc tion and high-dose regimens varied between contributing centres. A mai ntained CR was observed in 90% of patients. Early relapse was observed in 6%, and 4% suffered toxic deaths. With a median follow-up of 45 mo nths (3-112 months), the 5-year actuarial overall and progression-free survivals are both 70%. Nineteen (18%) patients relapsed at a median of 3.5 months (0.25-52 months) after ABMT, only 1 achieving a further durable CR. The only factor with prognostic significance was histologi cal subtype, with diffuse small noncleaved-cell lymphoma having a sign ificantly worse outcome. High-dose therapy and ABMT has produced effec tive consolidation of first remission in this group of patients, even in those with poor prognostic features at presentation.