Hodgkin and non-Hodgkin lymphoma: local-regional radiation therapy after bone marrow transplantation.
OBJECTIVE
To assess the acute toxicity and therapeutic effect of local-regional radiation therapy after bone marrow transplantation performed for lymphoma in resistant relapse.


METHODS
Twenty-one patients with Hodgkin (n = 12) or non-Hodgkin lymphoma (n = 9) underwent local-regional radiation therapy after bone marrow transplantation. Posttransplantation radiation was delivered to the dominant site of pretransplantation disease. Three patients with Hodgkin lymphoma and four with non-Hodgkin lymphoma underwent radiation therapy for posttransplantation recurrence. Total body irradiation was used in 10 patients. Mean radiation dose was lower in patients who underwent total body irradiation than in those who did not (P = .05).


RESULTS
Nineteen of 21 patients completed local-regional therapy. Nonhematologic toxicity was mild in 20 patients. Hematologic toxicity was severe in five patients, four of whom began radiation therapy with low platelet counts. In-field disease progression occurred in six of 15 patients with relapse, including four with disease progression at the start of radiation therapy. Median progression-free survival was 12 months in patients with Hodgkin lymphoma and 1 month in patients with non-Hodgkin lymphoma.


CONCLUSIONS
Posttransplantation local-regional radiation therapy can be safely administered in patients with lymphoma. Severe hematologic toxicity is a concern, however, in patients with low platelet counts.
Abrams
R A
RA
Department of Oncology, Johns Hopkins Oncology Center, Baltimore, MD 21287-8922, USA.
Liu
P J
PJ
Ambinder
R F
RF
Haulk
T L
TL
Korman
L T
LT
Herman
M G
MG
Jones
R J
RJ
D000293:Adolescent; D000328:Adult; D001773:Blood Cells / Q000528:radiation effects; D001792:Blood Platelets / Q000528:radiation effects; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000532:radiotherapy* / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000532:radiotherapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D010976:Platelet Count; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy; D012449:Safety; D015996:Survival Rate; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation