Treatment of patients with relapsed and resistant non-Hodgkin's Lymphoma using total body irradiation, etoposide, and cyclophosphamide and autologous bone marrow transplantation

Subhash Gulati, Joachim Yahalom, Luis Acaba, Lillian Reich, Robert Motzer, John Crown, Maria Toia, Tadahiko Igarashi, Roberto Lemoli, Enrique Hanninen, Maryanne Doherty

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Patients with non-Hodgkin's lymphoma (NHL) who do not achieve a complete response (CR) after induction chemotherapy or who relapse after achieving a CR are rarely cured of their disease by the usual salvage therapy. Success of high-dose cytotoxic therapy with an autologous bone marrow transplant (AuBMT) is limited. We describe the results of a prospective single-institution study using a new conditioning regimen for patients with relapsed or resistant NHL who underwent AuBMT. Patients and Methods: Forty-four patients were reinduced with cytotoxic therapy and then evaluated for response. All patients received the conditioning regimen of hyperfractionated total body irradiation (TBI), etoposide (VP-16), and cyclophosphamide (CTX) followed by autologous bone marrow reinfusion. Results: The disease-free survival (DFS) rate was 57% with a median follow-up of 42+ months. The only variable significantly associated with DFS was the patient's remission status at AuBMT. Patients who underwent AuBMT in CR had a DFS of 80%, whereas patients who underwent AuBMT in partial response (PR) or with progressive disease (PD) had a DFS of 60% and 11%, respectively (P = .002). The major toxicity was hemorrhage at the she of bulky disease, especially in patients with residual mediastinal and/or pulmonary disease. Conclusion: Planned reinduction cytotoxic therapy followed by TBI, VP-16, and CTX with AuBMT is an effective treatment for patients with relapsed and resistant NHL.

Original languageEnglish
Pages (from-to)936-941
Number of pages6
JournalJournal of Clinical Oncology
Volume10
Issue number6
Publication statusPublished - 1992

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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