VI Autologous Bone Marrow Transplantation.pdf - Blog Science ...

SUMMARY OF THE NON HODGKIN LYMPHOMA SESSION DURING
THE "SIXTH SYMPOSIUM ABMT" IN HOUSTON (DECEMBER 1992)
Professor Thierry PHILIP
First I want to thank Karel DICKE in the name of all the participants for this
very nice meeting and I like also to thank Karel for the good organization and
friendly period that we had in Houston.
I. As far as Nodular Lymphoma reports and posters are concerned we may
go back with the following messages:
- we have no major prognostic factors after marrow transplantation except
the very curious report from Boston that "no CR" before marrow transplant is a
favorable factor.
- bone marrow transplantation did not eliminate (14;18) translocation but
some people with persisting abnormality may be long term survivors.
- survival is equivalent with bone marrow transplantation and peripheral
blood stem cell transplantation.
- survival is equivalent with or without total body irradiation.
- survival is equivalent for different histology at least for follicular mixed
and follicular small cleaved.
- reports of very late relapses were made during the conference, specially by
Pr GORIN with one case of a ten years relapse after marrow transplantation.
CONCLUSION:
Nodular lymphoma is certainly a major field for bone marrow transplantation
in the future. It is still debatable whether we should use this modality of
therapy at the time of first CR or at the time of first relapse.
II. As far as intermediate and high grade Lymphomas are concerned we
may be going back with the following messages:
- Lymphoblastic Lymphomas are now widely grafted in 1st CR. Unfortunately,
we have no proof of the utility of this modality of therapy and I will
strongly recommend to organize prospective and randomized studies to definitively
prove the utility of marrow transplantation in this setting.
- for non-lymphoblastic lymphomas in 1st CR, the major study is coming for
the LNH Group and in the bad prognostic group of intermediate grade patients,
an intermediate report was done at ASCO1992, showing no difference between
bone marrow transplantation and normal conventional maintenance therapy in
this kind of lymphoma. However, we have to stress that this publication was
very early and that a difference may be shown in one or two years from now.
- we all agree that bone marrow transplantation in 1st PR is a very good indication.
Some evidence coming from Italy is in favor of this modality of therapy
in a randomized study and this is probably one of the consensual indications for
marrow transplantation at this time.
SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION 249