Long-term follow-up of autologous stem cell transplantation for patients with aggressive non-Hodgkin lymphoma who had bone marrow involvement at initial diagnosis in the pre-rituximab era.
BACKGROUND
High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is an important treatment option for selected patients with aggressive non-Hodgkin lymphoma; however, the effectiveness of HDT for patients with bone marrow (BM) involvement of lymphoma cells is not well defined.


METHODS
Between February 1991 and December 2001, 57 patients with aggressive non-Hodgkin lymphoma were treated with HDT and ASCT. Thirteen of 57 patients who had BM infiltration at initial diagnosis were analyzed.


RESULTS
Median follow-up was 11.5 years. Eleven of 13 patients (85%) exhibited complete remission after HDT. The overall survival (OS) at 10 years was 49%, and the median survival time was 74.3 months. Meanwhile, the probability of OS at 10 years for 44 patients who did not have BM disease was 60%. There was no significant difference in OS (P=0.895) between patients with or without BM disease at initial diagnosis.


CONCLUSIONS
High-dose therapy treatment followed by ASCT might save some groups of patients with lymphoma regardless of BM involvement at initial diagnosis.
Yano
Shingo
S
Department of Internal Medicine, Division of Hematology and Oncology, Jikei University School of Medicine, Tokyo, Japan. yano@jikei.ac.jp
Asai
Osamu
O
Dobashi
Nobuaki
N
Osawa
Hiroshi
H
Takei
Yutaka
Y
Takahara
Shinobu
S
Otsubo
Hiroko
H
Ogasawara
Yoji
Y
Yamaguchi
Yuko
Y
Saito
Takeshi
T
Minami
Jiro
J
Hoshi
Yasutaka
Y
Usui
Noriko
N
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D008875:Middle Aged; D012074:Remission Induction; D000069283:Rituximab; D015996:Survival Rate; D013995:Time; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab