Gh. Jackson et al., AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN POOR-RISK HIGH-GRADE NON-HODGKINS-LYMPHOMA IN FIRST COMPLETE REMISSION, British Journal of Cancer, 70(3), 1994, pp. 501-505
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.