title: Autotransplantation for relapsed or refractory non-Hodgkin's lymphoma (NHL): long-term follow-up and analysis of prognostic factors.
abstract: One hundred and thirty-six patients autografted for relapsed or refractory non-Hodgkin's lymphoma (NHL) were evaluated to assess long-term event-free survival and to identify important prognostic factors. High-dose therapy consisted primarily of carmustine (BCNU), etoposide, cytarabine, and cyclophosphamide (BEAC) followed by unpurged autologous stem cell rescue. The 5-year Kaplan-Meier event-free survival (EFS) for the entire cohort was 34% (95% confidence interval: 24-44%) with a median follow-up of approximately 3 years (range 0-7.5 years). For patients entering with minimal disease (defined as all areas < or = 2 cm), the 5-year EFS was 40 vs 26% for those entering with bulky disease (P = 0.0004). In the multivariate analysis, minimal disease on entry and administration of involved-field XRT post-transplant were significantly associated with improved EFS; the latter association was observed mainly in the cohort of patients with bulky disease. The overall 100-day treatment-related mortality rate was 4.4% (3% for the last 71 patients). New strategies are needed to reduce the high rate of relapse (50-60%) following auto-transplantation for relapsed or refractory NHL.
authors.affiliation: Department of Medicine, University of Rochester, School of Medicine and Dentistry, NY, USA.
authors.forename: A P
authors.initials: AP
authors.lastname: Rapoport
authors.forename: R
authors.initials: R
authors.lastname: Lifton
authors.forename: L S
authors.initials: LS
authors.lastname: Constine
authors.forename: R E
authors.initials: RE
authors.lastname: Duerst
authors.forename: C N
authors.initials: CN
authors.lastname: Abboud
authors.forename: J L
authors.initials: JL
authors.lastname: Liesveld
authors.forename: C H
authors.initials: CH
authors.lastname: Packman
authors.forename: S
authors.initials: S
authors.lastname: Eberly
authors.forename: R F
authors.initials: RF
authors.lastname: Raubertas
authors.forename: B A
authors.initials: BA
authors.lastname: Martin
authors.forename: W R
authors.initials: WR
authors.lastname: Flesher
authors.forename: P A
authors.initials: PA
authors.lastname: Kouides
authors.forename: J F
authors.initials: JF
authors.lastname: DiPersio
authors.forename: J M
authors.initials: JM
authors.lastname: Rowe
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018365:Neoplasm, Residual; D011379:Prognosis; D012008:Recurrence; D014182:Transplantation, Autologous