Journal of Clinical Oncology, Vol 10, 644-646, Copyright © 1992 by American Society of Clinical Oncology
Autologous bone marrow transplantation for adult poor-risk lymphoblastic lymphoma in first remission
LF Verdonck, AW Dekker, GC de Gast, HM Lokhorst and HK Nieuwenhuis
Department of Haematology, University Hospital Utrecht, The Netherlands.
PURPOSE: Adult patients with poor-risk lymphoblastic lymphoma (LBL) treated
with intensive multiagent chemotherapy (acute lymphoblastic leukemia
[ALL]-like regimens) have a poor prognosis, with a disease- free long-term
survival rate of less than 20%, caused by a very high relapse rate. Thus,
adult patients with poor-risk LBL are candidates for alternative intensive
consolidation therapy. PATIENTS AND METHODS: Nine adult patients with
poor-risk LBL in first remission after treatment with cyclophosphamide,
doxorubicin, vincristine, and prednisone (CHOP; six patients) or ALL-like
regimens (three patients), were treated with high-dose cyclophosphamide and
total body irradiation (TBI) followed by nonpurged autologous bone marrow
transplantation (ABMT). RESULTS: Two of nine patients relapsed at 4 and 8
months, respectively, after BMT, and one patient died of acute myeloblastic
leukemia (AML) 7 months after ABMT without recurrence of his lymphoma. Six
patients are in unmaintained first remission with a follow-up of 12 to 113
months (median, 53 months) after transplantation. CONCLUSIONS: These
results suggest that intensive consolidation therapy with high- dose
cyclophosphamide and TBI followed by nonpurged ABMT may improve the
long-term prognosis of this disease.
