title: Bone marrow transplantation prolongs survival after relapse in aggressive-lymphoma patients treated with the LNH-84 regimen.
abstract: OBJECTIVE
  Of the 737 patients with aggressive lymphoma who were treated with the LNH-84 regimen, 244 with progressive disease after complete remission or partial response were analyzed retrospectively to determine the influence of intensive chemotherapy with bone marrow transplantation (BMT) on survival.
  
  
  METHODS
  Forty-four patients were treated with salvage chemotherapy, followed by autologous bone marrow transplantation (ABMT) in 40 and allogeneic BMT in four. The other 200 patients were treated with chemotherapy only.
  
  
  RESULTS
  Salvage treatment produced an objective response in 57% of the patients; 23% achieved a second complete remission. Median overall survival was longer for patients who were treated with ABMT than for those who were treated with chemotherapy only (12.4 v 6.7 months), as was median freedom from progression (FFP) survival (7.7 v 4 months). In multiparametric analysis, ABMT and normal initial lactic dehydrogenase (LDH) level were the primary parameters associated with longer survival. This is also true when (1) only patients younger than 60 years of age, (2) only patients who responded to salvage regimen, or (3) only patients with both conditions were included in the analysis. Patients who were not transplanted had a 1.69 to 2.26 relative risk of dying from their disease compared with those who were treated with intensive chemotherapy plus ABMT.
  
  
  CONCLUSIONS
  This study produced more evidence of the favorable impact of intensive chemotherapy with bone marrow rescue on survival in lymphoma patients who had relapsed.
authors.affiliation: Cliniques Universitaires de Mont-Godinne, Yvoir, France.
authors.forename: A
authors.initials: A
authors.lastname: Bosly
authors.forename: B
authors.initials: B
authors.lastname: Coiffier
authors.forename: C
authors.initials: C
authors.lastname: Gisselbrecht
authors.forename: H
authors.initials: H
authors.lastname: Tilly
authors.forename: G
authors.initials: G
authors.lastname: Auzanneau
authors.forename: F
authors.initials: F
authors.lastname: Andrien
authors.forename: R
authors.initials: R
authors.lastname: Herbrecht
authors.forename: M
authors.initials: M
authors.lastname: Legros
authors.forename: Y
authors.initials: Y
authors.lastname: Devaux
authors.forename: J
authors.initials: J
authors.lastname: Jaubert
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D014751:Vindesine