Thirty-three patients with non-Hodgkin's lymphoma underwent autologous and 9 patients allogeneic hemopoietic stem cell transplantation. They were heterogeneous in terms of disease phase, previous treatment and histological varieties (11 lymphoblastic/Burkitt's, 16 large cell, and 15 intermediate/low grade non-Hodgkin's lymphoma); 35 patients were conditioned with a chemoradiotherapy combination and 7 with high-dose chemotherapy alone. Persistent bone marrow hypocellularity was the only indication for allogeneic transplantation. Thirty-three patients achieved complete remission; 3 died before engraftment and 6 were resistant. The median event-free survival of the entire series was 9 months (3-year chance: 41.69%): 7 months in primary resistant disease, 14 months in relapsing patients, and >42 months in patients transplanted during complete remission. As far as the histological subgroups were concerned, the median event-free survival was >53 months in intermediate/low grade, 5 months in lymphoblastic/Burkitt's, and 4 months in large cell non-Hodgkin's lymphoma (p = 0.02). Although these results are encouraging, the long-term event-free survival curves are much less favorable; however, many of the patients had advanced disease and therefore a negligible chance of event-free survival after conventional chemotherapy. The unfavorable outcomes of patients with refractory disease and large cell non- Hodgkin's lymphoma underscore the advantage of early hemopoietic stem cell transplantation which may minimize the occurrence of chemoresistance. Evaluation of the efficacy of hemopoietic stem cell transplantation to treat patients with intermediate/low grade non-Hodgkin's lymphoma necessitates a longer follow-up period. Clinical outcomes were similar after autologous and allogeneic transplantation; in the latter, the therapeutic role of a 'graft- versus-lymphoma' effect is still controversial.
|Number of pages||7|
|Journal||Annali Italiani di Medicina Interna|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Internal Medicine