Prolonged Disease-Free Survival after Autologous Bone Marrow Transplantation in Patients with Non-Hodgkin's Lymphoma with a Poor Prognosis

Publisher Website
Google Scholar
Abstract
Despite advances in the primary treatment of non-Hodgkin's lymphoma, relapse is common and treatment after relapse is unsatisfactory. Autologous bone marrow transplantation, although sometimes successful, has generally had disappointing results. We conducted a trial of such transplantation in patients with relapsed non-Hodgkin's lymphoma, using strict criteria in selecting patients; we included only those in whom disease was minimal after conventional treatment (nodal disease <2 cm and bone marrow involvement ≤5 percent on histologic examination) and whose tumor cells expressed the B1 antigen. Forty-nine patients meeting these criteria received cyclophosphamide and whole-body irradiation supported by transplantation of autologous bone marrow that had been treated in vitro with anti-B1 monoclonal antibody and complement. All patients had features of a poor prognosis, including relapse from primary chemotherapy, histologic conversion to more aggressive disease, and extranodal dissemination. Thirty-three patients had a history of bone marrow involvement — 16 at the time that marrow was obtained.