Autologous bone marrow transplantation for advanced stage adult lymphoblastic lymphoma in first complete remission. A pilot study of the non-Hodgkin's Lymphoma Co-operative Study Group (NHLCSG).
Twenty successive adult patients with lymphoblastic lymphoma entered a study of sequential chemotherapy consisting of an intensive LSA2-L2-type protocol to induce first complete remission. Twelve patients in first CR (median age 22 years, range 15-43), after receiving a conditioning regimen consisting of cyclophosphamide and total body irradiation, underwent autologous bone marrow transplantation. Of these 12 patients at diagnosis, one was in stage III and 11 in stage IV; 11 showed mediastinal and seven showed bone marrow involvement. The transplant procedure was well tolerated and no treatment-induced deaths occurred. At this time nine patients are alive and well 25-44 months post-transplant (median follow-up 36 months) with an actuarial disease-free survival of 75%. These early results suggest that high-dose chemoradiotherapy followed by autologous bone marrow transplantation may improve long-term disease-free survival in advanced stage adult lymphoblastic lymphoma. In order to draw definite conclusions, however, a larger and randomized study is needed.
Santini
G
G
Division of Hematology, Ospedale S. Martino, Genoa, Italy.
Coser
P
P
Chisesi
T
T
Porcellini
A
A
Sertoli
R
R
Contu
A
A
Congiu
A M
AM
Manna
A
A
Rossi
E
E
Scarpati
D
D
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002470:Cell Survival / Q000187:drug effects / Q000528:radiation effects; D003520:Cyclophosphamide / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D010865:Pilot Projects; D012074:Remission Induction; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation
D003520:Cyclophosphamide