title: High-dose therapy with autologous transplantation for aggressive non-Hodgkin's lymphoma: the Bologna experience.
abstract: Patients with aggressive non-Hodgkin's lymphoma (NHL) who relapse after initial therapy have a poor prognosis and with standard dose salvage therapy the outlook remains poor. In this work we examine the patient characteristics and outcome of patients with aggressive NHL treated with HDT and autologous transplantation at our Institute from 1982 to 1999. A retrospective analysis was performed examining patient characteristics, prior chemotherapy regimens, pretransplant disease status, HDT regimen, source of stem cells, time for hematopietic recovery, complications of transplantation, response rates, overall survival (OS) and relapse-free survival (RFS). One hundred and thirty-four patients with aggressive NHL were treated with estimated 10-year OS and RFS rates of 50% and 66%, respectively. Disease status (sensitive vs. refractory) pre-HDT was the most powerful predictive parameter for OS and RFS, at both univariate and multivariate analysis. For the entire cohort, transplant-related mortality was only 3.5% without evidence of second malignancies. Our results confirm that HDT with autologous transplantation is associated with a durable RFS in a remarkable proportion of aggressive NHL patients with very low global early and late toxicity. Improved patient selection, transplant timing, ongoing improvements in supportive care, and selected phase III trials should increase outcomes further.
authors.affiliation: Institute of Hematology and Medical Oncology L. e A. Seràgnoli, University of Bologna, Italy. plzinzo@med.unibo.it
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
authors.forename: Monica
authors.initials: M
authors.lastname: Tani
authors.forename: Annalisa
authors.initials: A
authors.lastname: Gabriele
authors.forename: Filippo
authors.initials: F
authors.lastname: Gherlinzoni
authors.forename: Antonello
authors.initials: A
authors.lastname: De Vivo
authors.forename: Paolo
authors.initials: P
authors.lastname: Ricci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bandini
authors.forename: Roberto Massimo
authors.initials: RM
authors.lastname: Lemoli
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Motta
authors.forename: Simonetta
authors.initials: S
authors.lastname: Rizzi
authors.forename: Valeria
authors.initials: V
authors.lastname: Guidice
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zompatori
authors.forename: Vittorio
authors.initials: V
authors.lastname: Stefoni
authors.forename: Lapo
authors.initials: L
authors.lastname: Alinari
authors.forename: Gerardo
authors.initials: G
authors.lastname: Musuraca
authors.forename: Enrica
authors.initials: E
authors.lastname: Marchi
authors.forename: Simona
authors.initials: S
authors.lastname: Bassi
authors.forename: Roberto
authors.initials: R
authors.lastname: Conte
authors.forename: Stefano
authors.initials: S
authors.lastname: Pileri
authors.forename: Sante
authors.initials: S
authors.lastname: Tura
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
mesh_terms: D000293:Adolescent; D000328:Adult; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D017077:Culture Media, Conditioned / Q000494:pharmacology; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D017077:Culture Media, Conditioned