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

AUTOLOGOUS BONE MARROW TRANSPLANTATION FOR LOW GRADE
NONHODGKIN'S LYMPHOMA: THE EUROPEAN BONE MARROW
TRANSPLANT GROUP (EBMT) EXPERIENCE.
H.C. Schouten, Ph. Colombat, L.F. Verdonck, N.C. Gorin, B. Bjorkstrand,
G. Taghipour, A.H. Goldstone on behalf of the EBMT
Working Party for Lymphoma.
Correspondence: H.C. Schouten M.D., Ph.D. University Hospital Maastricht,
Maastricht, the Netherlands.
INTRODUCTION
Non-localized low-grade non-Hodgkin's Lymphoma (NHL) is not a curable
disease. Influenced by the successful data of high-dose therapy in intermediate
and high-grade NHL, this treatment modality is increasingly applied in lowgrade
NHL . Only a few studies including limited numbers of patients have
been published ( M)
.
The Lymphoma Working Party of the European Bone Marrow Transplant
Group (EBMT) collects data on autologous bone marrow transplantation
(ABMT) for malignant lymphoma. In this registry 92 patients with low-grade
NHL could be identified who had been treated with high-dose therapy followed
by ABMT. Here, we present the results with a median follow-up of 19 months.
PATIENTS
The characteristics of the transplanted patients are listed in Table 1. The majority
of patients had chemo-sensitive disease in first or subsequent remission
(37%) or diasease with a good response to chemotherapy (49%). The median
time from diagnosis to ABMT was 20 months. At time of transplant 19 patients
had marrow involvement and 27 patients received a purged autograft. The majority
of patients (53/92) received a chemo-only pretransplant conditioning regimen.
RESULTS
Only 3 toxic deaths were reported. The results for progression free survival
are shown in figure 1. CR or responding relapse at the time of ABMT was related
with a better progression free survival (see figure 2). The application of TBI
in the pre-transplant conditioning or the use of purged autografts did not have
any impact on outcome (figures 3 and 4). Age of the patients at ABMT was not
of any influence on progression free survival (data not shown).
CONCLUSIONS
This is the largest series reported of patients with low-grade NHL treated
with high-dose therapy followed by ABMT. Progression free survival after
ABMT is very promising. The data support the observations done in other types
of NHL that chemosensitive disease reponds better to high-dose therapy fol-
Sixm INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION 71