autologous blood and marrow transplantation - Blog Science ...

178 Chapter 4: Lymphoma
100
80
%OS
60
40
20
P < 0.000001
Lbl N= 244
J Burkitt's N= 75
3 6 9 12 15 18
Years
Figure 5. Actuarial overall survival from the date of relapse according to histologic subtype,
EBMT patients.
had Hodgkin's disease, and three of the five patients with NHL were receiving
therapy at the time of the report.
Results from both groups of patients in the present study confirm the poor
outlook for these patients. In the Southampton series, the median overall survival
from the date of relapse was 3 months. Most of the patients in this group had
diffuse large B cell lymphoma, and the median survival is identical to that for
intermediate-grade patients in the Nebraska series. Although the median survival
for all patients in the EBMT series is longer at 1 year, 14% of the patients in this
series had low-grade disease, which, as shown in Fig. 5, has a significantly longer
survival (median 16 months) after relapse compared with aggressive NHL. Those
with aggressive NHL have a median survival of between 2 and 6 months, according
to histologic subtype.
Patterns of relapse
Patterns of relapse have been documented infrequently in previous reports. In
the series by Peterson et al., 9
59 patients (95%) relapsed in previously involved
sites, although the report does not indicate whether these relapses were localized or
whether more distant sites were also involved. Of 100 patients with B cell NHL
treated with high-dose cyclophosphamide and TBI plus monoclonal anti-B cell
purged autologous BMT at the Dana Farber Cancer Institute, 35 patients relapsed. 7
Twenty-three of these patients relapsed only in previously involved sites, seven in