[Successful high-dose chemotherapy combined with autologous bone marrow transplantation in a case of refractory follicular lymphoma].
A 34-year-old patient with follicular lymphoma who was treated with CHOP followed by COPP for 3 years, became resistant to treatment in December 1993. Histological findings and surface markers of cervical lymph node cells revealed no change from previous findings. Tumor cell involvement of bone marrow was also observed by molecular analysis of DNA fragments with bcl-2 oncogene and J-H gene probes. Following 2 courses of salvage chemotherapy with NOAC-M regimen (novantrone, cytarabine and methylprednisolone), There was an 88% reduction of tumor mass on computed tomographic findings. Through the use of polymerase chain reaction analysis of residual cells with the bcl-2 translocation, we confirmed the in vivo purging of tumor cells from bone marrow and we harvested marrow cells for autologous transplantation. After high-dose chemotherapy (HDC) with ranimustine, cisplatin, etoposide and cyclophosphamide followed by bone marrow transplantation (BMT), complete remission was achieved. The patient has survived for 16 months and remains disease free. The standard chemotherapy regimen for advanced low grade non-Hodgkin's lymphoma has not yet been defined. Although we must follow this patient carefully to determine the effect of HDC with BMT for a long time, this seems to be an effective complementary treatment for patients responding to conventional salvage regimens.
Nagai
T
T
Sapporo Kitano Hospital.
Hirayama
Y
Y
Ohta
H
H
Koyama
R
R
Matsunaga
T
T
Kuga
T
T
Sakamaki
S
S
Niitsu
Y
Y
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation / Q000379:methods*; D016190:Carboplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008224:Lymphoma, Follicular / Q000628:therapy*; D008297:Male; D009607:Nitrosourea Compounds / Q000008:administration & dosage; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D009607:Nitrosourea Compounds; D005047:Etoposide; D003520:Cyclophosphamide; D016190:Carboplatin; C020766:ranimustine