DURABILITY OF REMISSION AFTER ABMT FOR NHL - THE IMPORTANCE OF THE 2-YEAR EVALUATION POINT

Few series describing the results of autologous bone marrow transplant ation (ABMT) for the treatment of non-Hodgkin's lymphoma report mature follow-up, We retrospectively reviewed 110 adults with NHL treated wi th ABMT from 1988 to 1993, Overall survival and relapse-free survival were 50% and 35%, respectively, Estimated median relapse-free survival was 16 months, There was no statistically significant difference in r elapse-free or overall survival by low, intermediate, and high-grade h istologies, as defined by the International Working Formulation, The m ost powerful negative prognostic variable was an elevated LDH at the t ime of transplant (relapse-free survival 17% vs 42% for those with a n ormal LDH), Forty-seven patients were in complete remission 2 years af ter transplant, Extended follow-up revealed that 100% of patients with high-grade histologies remained in complete remission, whereas patien ts with intermediate-grade and low-grade histologies remained at risk of relapse with longer follow-up, Of 22 patients with diffuse large ce ll lymphoma (LCL) or immunoblastic (IBL) histologies, eight of eight w ith IBL remain in continued remission, while four of 14 with LCL relap sed 24-48 months after ABMT, We conclude that patients with high-grade histologic subtypes of NHL who are in complete remission 2 years afte r ABMT are likely to be cured, However, patients with intermediate and low-grade histologic subtypes are at continued risk of relapse and re quire appropriate clinical surveillance for at least 48 months after A BMT.