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. 1994 Sep;70(3):501–505. doi: 10.1038/bjc.1994.335

Autologous bone marrow transplantation in poor-risk high-grade non-Hodgkin's lymphoma in first complete remission. Newcastle and Northern Lymphoma Group.

G H Jackson 1, A L Lennard 1, P R Taylor 1, P Carey 1, B Angus 1, H Lucraft 1, R G Evans 1, S J Proctor 1
PMCID: PMC2033362  PMID: 7521662

Abstract

We report the safety and efficacy of autologous bone marrow transplantation (ABMT) in 30 patients with high-grade non-Hodgkin's lymphoma (NHL) in first complete remission (CR1) following remission induction chemotherapy. Two patients relapsed prior to ABMT. All patients were conditioned with high-dose melphalan. In Addition, ten received fractionated total body irradiation, one hemi-body irradiation and four high-dose etoposide. Unmanipulated non-cryopreserved autologous marrow was reinfused within 56 h of harvesting. Engraftment occurred in all patients with a median of 11 days of neutropenia (< 0.5 x 10(9) l-1), a median requirement for platelet transfusion of 3 days and packed red cell transfusion of 2 units, with a median hospital stay of 18 days post transplant. There was no procedure-related mortality and only minor morbidity was observed. Two patients relapsed at 1 and 2 months post transplantation, and one patient died of carcinoma of the lung 33 months after transplantation. The remaining 25 patients remain alive, well and in CR1 with a median follow-up of 44 months. The event-free survival at 3 years for all patients considered for ABMT was 83%. We conclude that ABMT for high-grade NHL in CR1 with non-cryopreserved marrow results in rapid haematological recovery without growth factor support. It is safe and is associated with high survival when used as consolidation of CR in high-risk patients.

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Selected References

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  1. Anderson C. C., Goldstone A. H., Linch D. C., Jones H. M., Franklin I. M., Boughton B. J., Cawley J. C., Richards J. D. Autologous bone marrow transplantation for patients with acute myeloid leukaemia and acute lymphoblastic leukaemia--a comparison. Bone Marrow Transplant. 1987 Feb;1(3):271–279. [PubMed] [Google Scholar]
  2. Armitage J. O., Weisenburger D. D., Hutchins M., Moravec D. F., Dowling M., Sorensen S., Mailliard J., Okerbloom J., Johnson P. S., Howe D. Chemotherapy for diffuse large-cell lymphoma--rapidly responding patients have more durable remissions. J Clin Oncol. 1986 Feb;4(2):160–164. doi: 10.1200/JCO.1986.4.2.160. [DOI] [PubMed] [Google Scholar]
  3. Bender J. G., Williams S. F., Myers S., Nottleman D., Lee W. J., Unverzagt K. L., Walker D., To L. B., Van Epps D. E. Characterization of chemotherapy mobilized peripheral blood progenitor cells for use in autologous stem cell transplantation. Bone Marrow Transplant. 1992 Sep;10(3):281–285. [PubMed] [Google Scholar]
  4. Carey P. J., Proctor S. J., Taylor P., Hamilton P. J. Autologous bone marrow transplantation for high-grade lymphoid malignancy using melphalan/irradiation conditioning without marrow purging or cryopreservation. The Northern Regional Bone Marrow Transplant Group. Blood. 1991 Apr 1;77(7):1593–1598. [PubMed] [Google Scholar]
  5. Coiffier B., Gisselbrecht C., Herbrecht R., Tilly H., Bosly A., Brousse N. LNH-84 regimen: a multicenter study of intensive chemotherapy in 737 patients with aggressive malignant lymphoma. J Clin Oncol. 1989 Aug;7(8):1018–1026. doi: 10.1200/JCO.1989.7.8.1018. [DOI] [PubMed] [Google Scholar]
  6. Coleman C. N., Picozzi V. J., Jr, Cox R. S., McWhirter K., Weiss L. M., Cohen J. R., Yu K. P., Rosenberg S. A. Treatment of lymphoblastic lymphoma in adults. J Clin Oncol. 1986 Nov;4(11):1628–1637. doi: 10.1200/JCO.1986.4.11.1628. [DOI] [PubMed] [Google Scholar]
  7. Colombat P., Gorin N. C., Lemonnier M. P., Binet C., Laporte J. P., Douay L., Desbois I., Lopez M., Lamagnere J. P., Najman A. The role of autologous bone marrow transplantation in 46 adult patients with non-Hodgkin's lymphomas. J Clin Oncol. 1990 Apr;8(4):630–637. doi: 10.1200/JCO.1990.8.4.630. [DOI] [PubMed] [Google Scholar]
  8. Freedman A. S., Takvorian T., Neuberg D., Mauch P., Rabinowe S. N., Anderson K. C., Soiffer R. J., Spector N., Grossbard M., Robertson M. J. Autologous bone marrow transplantation in poor-prognosis intermediate-grade and high-grade B-cell non-Hodgkin's lymphoma in first remission: a pilot study. J Clin Oncol. 1993 May;11(5):931–936. doi: 10.1200/JCO.1993.11.5.931. [DOI] [PubMed] [Google Scholar]
  9. Gribben J. G., Goldstone A. H., Linch D. C., Taghipour G., McMillan A. K., Souhami R. L., Earl H., Richards J. D. Effectiveness of high-dose combination chemotherapy and autologous bone marrow transplantation for patients with non-Hodgkin's lymphomas who are still responsive to conventional-dose therapy. J Clin Oncol. 1989 Nov;7(11):1621–1629. doi: 10.1200/JCO.1989.7.11.1621. [DOI] [PubMed] [Google Scholar]
  10. Gribben J. G., Vaughan Hudson B., Linch D. C. The potential value of very intensive therapy with autologous bone marrow rescue in the treatment of malignant lymphomas. Hematol Oncol. 1987 Oct-Dec;5(4):281–293. doi: 10.1002/hon.2900050406. [DOI] [PubMed] [Google Scholar]
  11. Hayward R. L., Leonard R. C., Prescott R. J. A critical analysis of prognostic factors for survival in intermediate and high grade non-Hodgkin's lymphoma. Scotland and Newcastle Lymphoma Group Therapy Working Party. Br J Cancer. 1991 Jun;63(6):945–952. doi: 10.1038/bjc.1991.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kessinger A., Armitage J. O., Smith D. M., Landmark J. D., Bierman P. J., Weisenburger D. D. High-dose therapy and autologous peripheral blood stem cell transplantation for patients with lymphoma. Blood. 1989 Sep;74(4):1260–1265. [PubMed] [Google Scholar]
  13. Nademanee A., Schmidt G. M., O'Donnell M. R., Snyder D. S., Parker P. A., Stein A., Smith E., Lipsett J. A., Sniecinski I., Margolin K. High-dose chemoradiotherapy followed by autologous bone marrow transplantation as consolidation therapy during first complete remission in adult patients with poor-risk aggressive lymphoma: a pilot study. Blood. 1992 Sep 1;80(5):1130–1134. [PubMed] [Google Scholar]
  14. Petersen F. B., Appelbaum F. R., Hill R., Fisher L. D., Bigelow C. L., Sanders J. E., Sullivan K. M., Bensinger W. I., Witherspoon R. P., Storb R. Autologous marrow transplantation for malignant lymphoma: a report of 101 cases from Seattle. J Clin Oncol. 1990 Apr;8(4):638–647. doi: 10.1200/JCO.1990.8.4.638. [DOI] [PubMed] [Google Scholar]
  15. Pettengell R., Morgenstern G. R., Woll P. J., Chang J., Rowlands M., Young R., Radford J. A., Scarffe J. H., Testa N. G., Crowther D. Peripheral blood progenitor cell transplantation in lymphoma and leukemia using a single apheresis. Blood. 1993 Dec 15;82(12):3770–3777. [PubMed] [Google Scholar]
  16. Philip T., Hartmann O., Biron P., Cahn J. Y., Pein F., Bordigoni P., Souillet G., Gartner M., Lasset C., Chauvin F. High-dose therapy and autologous bone marrow transplantation in partial remission after first-line induction therapy for diffuse non-Hodgkin's lymphoma. J Clin Oncol. 1988 Jul;6(7):1118–1124. doi: 10.1200/JCO.1988.6.7.1118. [DOI] [PubMed] [Google Scholar]
  17. Phillips G. L., Herzig R. H., Lazarus H. M., Fay J. W., Wolff S. N., Mill W. B., Lin H., Thomas P. R., Glasgow G. P., Shina D. C. Treatment of resistant malignant lymphoma with cyclophosphamide, total body irradiation, and transplantation of cryopreserved autologous marrow. N Engl J Med. 1984 Jun 14;310(24):1557–1561. doi: 10.1056/NEJM198406143102403. [DOI] [PubMed] [Google Scholar]
  18. Proctor S. J., Hamilton P. J., Taylor P., Carey P., Hargrave S., Evans R. G., Summerfield G., Finney R., Saunders P., Goff D. A comparative study of combination chemotherapy versus marrow transplant in first remission in adult acute lymphoblastic leukaemia. Br J Haematol. 1988 May;69(1):35–39. doi: 10.1111/j.1365-2141.1988.tb07599.x. [DOI] [PubMed] [Google Scholar]
  19. Skarin A. T. Diffuse aggressive lymphomas: a curable subset of non-Hodgkin's lymphomas. Semin Oncol. 1986 Dec;13(4 Suppl 5):10–25. [PubMed] [Google Scholar]
  20. Taylor P. R., Jackson G. H., Lennard A. L., Lucraft H., Proctor S. J. Autologous transplantation in poor risk Hodgkin's disease using high dose melphalan/etoposide conditioning with non-cryopreserved marrow rescue. The Newcastle and Northern Region Lymphoma Group. Br J Cancer. 1993 Feb;67(2):383–387. doi: 10.1038/bjc.1993.70. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. To L. B., Roberts M. M., Haylock D. N., Dyson P. G., Branford A. L., Thorp D., Ho J. Q., Dart G. W., Horvath N., Davy M. L. Comparison of haematological recovery times and supportive care requirements of autologous recovery phase peripheral blood stem cell transplants, autologous bone marrow transplants and allogeneic bone marrow transplants. Bone Marrow Transplant. 1992 Apr;9(4):277–284. [PubMed] [Google Scholar]

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