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Autologous bone marrow transplantation for non-Hodgkin's lymphoma in first remission.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Sierra, Jorge Conde, Eduardo Gómez Montserrat, E. |
| Copyright Year | 1993 |
| Abstract | We have read with interest the recent report of a pilot study exploring the role of autologous bone marrow transplants (ABMT) in patients with poor-risk non-Hodgkin's lymphoma (NHL) in first remission.' We agree in that this approach has to be further investigated. This also raises the need to identify prognostic factors in these patients. In this context the Spanish Cooperative Group GEL/TAMO experience can be of interest. Among 132 patients from the GEL/TAMO autografted for NHL?3 5 I received transplants while in first remission. Their characteristics are shown in Table 1. With a median follow-up of 21 months, 40 patients are alive with a disease-free survival (DFS) and a relapse rate at 8 years Of 77% (95% confidence interval [CI], 65-89) and 10% (95% CI, 4I8), respectively (Fig I ) . Toxic deaths occurred in 14% ofcases. In the multivariate analysis of the prognostic factors, only LDH at diagnosis showed independent prognostic value for DFS after transplant (P = .015) (Table 2), the best discriminant level being 600 IU/L. Interestingly, age, histology. clinical stage. number of regimens needed to achieve the remission, interval between complete remission and ABMT, and conditioning regimen were of no predictive value. This larger series confirms that in patients with NHL in first remission autologous transplants are feasible and can produce prolonged DFS, although the toxicity of the procedure may not be negligible. Of note, a well-known prognostic parameter at diagnosis (namely, LDH level) that identifies patients not likely to be cured with conventional chemotherapy4 is also correlated with a shorter DFS after transplant. Finally, because patients with aggressive lymphoma in remission constitute a highly selected population and response to therapy is an important prognostic parameter in itself: we agree that randomized trials are mandatory to establish the role of ABMT as front-line therapy for lymphomas. |
| File Format | PDF HTM / HTML |
| PubMed reference number | 8461480 |
| Journal | Medline |
| Volume Number | 81 |
| Issue Number | 7 |
| Alternate Webpage(s) | http://www.bloodjournal.org/content/bloodjournal/81/7/1968.full.pdf?sso-checked=true |
| Journal | Blood |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
