Long-term follow-up of autologous bone marrow transplantation in patients with relapsed follicular lymphoma

We report the results of high-dose chemoradiotherapy and anti-B-cell monocl onal antibody-purged autologous bone marrow transplantation (ABMT) in patie nts with relapsed indolent follicular lymphoma. Between March 1985 and May 1995, 153 patients underwent ABMT using a uniform ablative regimen with cyc lophosphamide and total body irradiation and bone marrow (BM) purging. All patients received multiple chemotherapy regimens before ABMT. At BM harvest , only 30% of patients were in complete remission, and overt BM infiltratio n was present in 47%. The disease-free survival (DFS) and overall survival (OS) are estimated to be 42% and 66% at 8 years, respectively. Patients who se BM was negative by polymerase chain reaction (PCR) for bc12/IgH rearrang ement after purging experienced longer freedom from recurrence than those w hose BM remained PCR positive (P < .0001). Continued PCR negativity in foll ow-up BM samples was also strongly predictive of continued complete remissi on (CR). The 12-year survival from diagnosis for these 153 patients is 69%. Considering that the median survival from diagnosis and first recurrence o f patients with advanced follicular lymphoma are 8 and 5 years, respectivel y, our results provide evidence that myeloablative therapy and ABMT may pro long overall survival. (C) 1999 by The American Society of Hematology.