High-Dose Therapy and Autologous Peripheral Blood Stem Cell Transplantation for Patients With Lymphoma

• Published in: Blood 1989-09, Vol.74 (4), p.1260-1265
• Main Authors: Kessinger, Anne, Armitage, James O., Smith, Douglas M., Landmark, James D., Bierman, Philip J., Weisenburger, Dennis D.
• Format: Article
• Language: English
• Subjects: Actuarial Analysis; Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Blood Transfusion, Autologous; Carmustine; Child; Cyclophosphamide; Drug Administration Schedule; Etoposide; Female; Follow-Up Studies; Hematologic and hematopoietic diseases; Hematopoiesis; Hematopoietic Stem Cell Transplantation; Hodgkin Disease - drug therapy; Hodgkin Disease - mortality; Hodgkin Disease - therapy; Humans; Leukapheresis; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Non-Hodgkin - drug therapy; Lymphoma, Non-Hodgkin - mortality; Lymphoma, Non-Hodgkin - therapy; Male; Medical sciences; Middle Aged
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V74.4.1260.1260

Forty patients with refractory Hodgkin's disease (24 patients) or non-Hodgkin's lymphoma (16 patients) who were considered for high-dose therapy but not for autologous bone marrow transplantation (ABMT) due to BM metastases, previous pelvic irradiation, a history of marrow involvement by tumor or hypocellular marrow in conventional harvest sites received high-dose therapy and autologous peripheral blood (PB) hematopoietic stem cell transplantation. Disappearance of circulating neutrophils and development of RBC and platelet transfusion-dependence was followed, in the evaluable patients, by reappearance of 0.5 × 109/L circulating granulocytes and sufficient platelets to obviate the need for platelet transfusions at a median of 25 days after transplantation. Twenty-three patients experienced a clinical complete remission (CR). The projected 2-year event-free survival was 20% for all 40 patients and 49% for the non-Hodgkin's lymphoma patients. The projected 18-month event-free survival for the Hodgkin's disease patients was 15%. PB stem cell transplantation provided an opportunity to administer high-dose salvage therapy to patients with refractory lymphoma who otherwise were not candidates for such therapy. For some of those patients, the high-dose therapy produced prolonged survival, free of tumor progression.