title: The Stanford experience with high-dose etoposide cytoreductive regimens and autologous bone marrow transplantation in Hodgkin's disease and non-Hodgkin's lymphoma: preliminary data.
abstract: Seventy-seven Hodgkin's disease and non-Hodgkin's lymphoma (NHL) patients received high-dose etoposide in combination with cyclophosphamide and either fractionated total body irradiation (TBI) (n = 28) or carmustine (n = 49) prior to autologous bone marrow transplantation. Marrow from NHL patients was purged in vitro with a panel of monoclonal B- and T-cell antibodies and complement. Six toxic deaths (8%) occurred, all in patients who received carmustine. With a median follow-up of 1 year, 57 patients are alive and free from progressive disease. The 1-year actuarial survival and freedom from progression are 85 and 73% in fractionated TBI/etoposide/cyclophosphamide-treated patients and 79 and 72% in carmustine/etoposide/cyclophosphamide-treated patients. Forty-five of these patients participated in prospective trials for which eligibility criteria were (1) less than 25% curability with conventional therapy; (2) achievement of minimal disease state with conventional therapy; and (3) transplantation early in the course of disease. One-year actuarial survival for 18 patients with relapsed Hodgkin's disease is 80% and for 21 relapsed intermediate and high-grade NHL patients, 70%. One NHL Burkitt's patient was transplanted on a protocol for high-risk intermediate and high-grade NHL in first remission. Five patients with follicular mixed or small cleaved NHL were also transplanted in first remission.
authors.affiliation: Department of Medicine, Stanford University Medical Center, California.
authors.forename: S J
authors.initials: SJ
authors.lastname: Horning
authors.forename: N J
authors.initials: NJ
authors.lastname: Chao
authors.forename: R S
authors.initials: RS
authors.lastname: Negrin
authors.forename: R T
authors.initials: RT
authors.lastname: Hoppe
authors.forename: L W
authors.initials: LW
authors.lastname: Kwak
authors.forename: G D
authors.initials: GD
authors.lastname: Long
authors.forename: B
authors.initials: B
authors.lastname: Stallbaum
authors.forename: P
authors.initials: P
authors.lastname: O'Connor
authors.forename: K G
authors.initials: KG
authors.lastname: Blume
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002330:Carmustine / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004341:Drug Evaluation; D005047:Etoposide / Q000008:administration & dosage; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation
chemical_list: D005047:Etoposide; D003520:Cyclophosphamide; D002330:Carmustine