High-dose chemotherapy with autologous bone marrow transplantation: 11 years' experience in Zurich

High-dose chemotherapy with autologous bone marrow or peripheral blood stem cell transplantation has gained widespread acceptance for the treatment of certain malignancies. Since the introduction of this therapy in 1988 we ha ve treated 272 patients. Indications for high-dose chemotherapy were high-r isk large cell lymphoma and lymphoblastic or Burkitt lymphoma in first remi ssion (73 patients), non-Hodgkin's lymphoma in chemosensitive relapse (65 p atients), Hodgkin's lymphoma in relapse (52 patients), germ cell tumours wi th inadequate response to chemotherapy (34 patients), multiple myeloma (29 patients), and other malignancies (19 patients). Treatment mortality was 1. 8%. The 3-year event-free survival and overall survival for all patients we re 48 and 61% respectively. High-dose chemotherapy with autologous stern ce ll transplantation has become a safe procedure and is considered the treatm ent of choice for relapsed large cell lymphoma, relapsed Hodgkin's disease, stage II or III multiple myeloma, and germ cell rumours with inadequate re sponse to cisplatin-based chemotherapy In other situations, including aggre ssive lymphoma with risk factors, acute leucaemia or breast cancer, the sup eriority of high-dose over conventional chemotherapy remains to be proven. Patients with such diseases should not receive high-dose chemotherapy outsi de a controlled clinical study.