High-dose therapy and autologous peripheral blood stem cell transplantation for patients with lymphoma.
Forty patients with refractory Hodgkin's disease (24 patients) or non-Hodgkin's lymphoma (16 patients) who were considered for high-dose therapy but not for autologous bone marrow transplantation (ABMT) due to BM metastases, previous pelvic irradiation, a history of marrow involvement by tumor or hypocellular marrow in conventional harvest sites received high-dose therapy and autologous peripheral blood (PB) hematopoietic stem cell transplantation. Disappearance of circulating neutrophils and development of RBC and platelet transfusion-dependence was followed, in the evaluable patients, by reappearance of 0.5 x 10(9)/L circulating granulocytes and sufficient platelets to obviate the need for platelet transfusions at a median of 25 days after transplantation. Twenty-three patients experienced a clinical complete remission (CR). The projected 2-year event-free survival was 24% for all 40 patients and 49% for the non-Hodgkin's lymphoma patients. The projected 18-month event-free survival for the Hodgkin's disease patients was 15%. PB stem cell transplantation provided an opportunity to administer high-dose salvage therapy to patients with refractory lymphoma who otherwise were not candidates for such therapy. For some of those patients, the high-dose therapy produced prolonged survival, free of tumor progression.
Kessinger
A
A
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68105.
Armitage
J O
JO
Smith
D M
DM
Landmark
J D
JD
Bierman
P J
PJ
Weisenburger
D D
DD
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001804:Blood Transfusion, Autologous; D002330:Carmustine; D002648:Child; D003520:Cyclophosphamide; D004334:Drug Administration Schedule; D005047:Etoposide; D005260:Female; D005500:Follow-Up Studies; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007937:Leukapheresis; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged
D005047:Etoposide; D003520:Cyclophosphamide; D002330:Carmustine