Autologous bone marrow transplantation in B-cell non-Hodgkin's lymphoma: very low treatment-related mortality in 100 patients in sensitive relapse.

Abstract

One hundred patients with B-cell non-Hodgkin's lymphoma (NHL) in sensitive relapse or incomplete first remission underwent high-dose chemoradiotherapy and anti-B-cell monoclonal antibody (MAb)-treated autologous bone marrow transplantation (ABMT). These patients demonstrated good performance status with a Karnofsky score of 80% or greater. The majority of these patients had one or more adverse prognostic features including a failure to achieve a complete remission (CR) with conventional combination chemotherapy (37 patients), bone marrow infiltration (69 patients), a history of extranodal disease other than bone marrow infiltration (42 patients), and histologic conversion (18 patients). At the time of ABMT, only 52 patients were in CR; however, all patients achieved a minimal disease state following conventional intensive therapy. Moreover, at the time of marrow harvest, 37 of these patients had histologic evidence of lymphoma cells infiltrating the marrow. Following high-dose ablative therapy, two acute in-hospital treatment-related deaths were observed. Two late deaths were observed, not due to recurrent lymphoma. Of the remaining 96 patients, 61 are in unmaintained CR with a median follow-up of 13 months. Kaplan-Meier actuarial analysis predicts 50% probability of disease-free survival (DFS) at 37.8 months. This very low treatment-related mortality provides the rationale to apply high-dose therapy and ABMT as consolidative therapy for patients in first remission who are at high risk for relapse following conventional therapy.

Autologous transplantation for relapsed non-Hodgkin's lymphoma using intravenous busulfan and cyclophosphamide as conditioning regimen: a single center experience

“…However, our transplant-related mortality rate (9%) is slightly higher than the reported average early treatmentrelated mortality of 5% or less. 19,20 On the other hand, we have not observed any cases of secondary myelodysplasia (MDS) or treatment-related AML during a median followup period of 29 months after transplantation. Some studies have shown a relatively high incidence of secondary MDS as a late complication of autologous SCT with relative risk as high as to 18% at 6 years.…”

High-dose therapy with autologous or allogeneic transplantation as salvage therapy for small cleaved cell lymphoma of follicular center cell origin

“…Some studies include only a minority of patients with low-grade lymphoma among patients with intermediate-or high-grade lymphoma. 13,14,30,31 Studies of low-grade lymphoma may include several histologic types of lymphoma with different natural histories, such as mixed cell lymphoma (large cleaved cell lymphoma 5,6,11 and unrecognized cases of mantle cell lymphoma. It is in this context that we report our experience with 51 patients who received autologous or allogeneic transplantation as salvage therapy for documented SCCL.…”

Pre-transplantation physical and mental functioning is strongly associated with self-reported recovery from stem cell transplantation

“…These transplant protocols have been published. [10][11][12][13][14] Quality of life instruments Patients were surveyed by mail before hospital admission and at 6 and 12 months post HCT. The survey solicited qualitative information on symptoms, self-assessment of health, feelings about the transplantation procedure and sense of recovery after transplantation.…”