Limited Efficacy of Intensified Preparative Regimens and Autologous Transplantation as Salvage Therapy in High Grade Non-Hodgkin's Lymphoma

Abstract

Between 9/86 and 6/98, 22 patients with relapsed or refractory high grade lymphoma received intensified preparative therapy and underwent autologous transplantation at a single instituttion. Two intensified preparative regimens were used - cyclophosphamide, etoposide, total body irradition (CY-VP-TBI) (N=17) and cyclophosphamide, BCNU, etoposide (CBV) (N=5). For all patients undergoing autologous transplantation, 5 year events free survival (EFS) were only 18% ± 8%. Treatment related mortality was 14% overall but only 8% in patients receiving G-CSF or GM-CSF. Surveival was significantly inferior to the survival observed in a concurrent series of patients with intermediate grade lymphoma, 34% ± 6%, p <. 05. Using high dose therapy in conjunction with autologous transplantation at the time of relapse may not be a valuable a strategy in high-grade lymphoma as in intermediate grade lymphoma although most studies combine the two disorders. Alternative strategies for the use of transplantation in high grade lymphoma, such as the use of transplantation as consolidation therapy, need to be investigated.

Key Words:

• Lymphoma
• high-grade
• autologous