AUTOTRANSPLANTATION FOR RELAPSED OR REFRACTORY NON-HODGKINS-LYMPHOMA (NHL) - LONG-TERM FOLLOW-UP AND ANALYSIS OF PROGNOSTIC FACTORS

One hundred and thirty-six patients autografted for relapsed or refrac tory non-Hodgkin's lymphoma (NHL) were evaluated to assess long-term e vent-free survival and to identify important prognostic factors. High- dose therapy consisted primarily of carmustine (BCNU), etoposide, cyta rabine, and cyclophosphamide (BEAC) followed by unpurged autologous st em cell rescue. The 5-year Kaplan-Meier event-free survival (EFS) for the entire cohort was 34% (95% confidence interval: 24-44%) with a med ian follow-up of approximately 3 years (range 0-7.5 years). For patien ts entering with minimal disease (defined as all areas less than or eq ual to 2 cm), the 5-year EFS was 40 vs 26% for those entering with bul ky disease (P = 0.0004). In the multivariate analysis, minimal disease on entry and administration of involved-field XRT posttransplant were significantly associated with improved EFS; the latter association wa s observed mainly in the cohort of patients with bulky disease. The ov erall 100-day treatment-related mortality rate was 4.4% (3% for the la st 71 patients). New strategies are needed to reduce the high rate of relapse (50-60%) following autotransplantation for relapsed or refract ory NHL.