AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN POOR-RISK HIGH-GRADE NON-HODGKINS-LYMPHOMA IN FIRST COMPLETE REMISSION

We report the safety and efficacy of autologous bone marrow transplant ation (ABMT) in 30 patients with high-grade non-Hodgkin's lymphoma (NH L) in first complete remission (CR1) following remission induction che motherapy. Two patients relapsed prior to ABMT. All patients were cond itioned with high-dose melphalan. In addition, ten received fractionat ed total body irradiation, one hemi-body irradiation and four high-dos e etoposide. Unmanipulated non-cryopreserved autologous marrow was rei nfused within 56h of harvesting. Engraftment occurred in all patients with a median of 11 days of neutropenia (<0.5 x 10(9) 1(-1)), a median requirement for platelet transfusion of 3 days and packed red cell tr ansfusion of 2 units, with a median hospital stay of 18 days post tran splant. There was no procedure-related mortality and only minor morbid ity was observed. Two patients relapsed at 1 and 2 months post transpl antation, and one patient died of carcinoma of the lung 33 months afte r transplantation. The remaining 25 patients remain alive, well and in CR1 with a median follow-up of 44 months. The event-free survival at 3 years for all patients considered for ABMT was 83%. We conclude that ABMT for high-grade NHL in CR1 with noncryopreserved marrow results i n rapid haematoiogical recovery without growth factor support. It is s afe and is associated with high survival when used as consolidation of CR in high-risk patients.