Autologous Bone Marrow Transplantation - Blog Science Connections

252 ABMT in Burkitt's Lymphoma
intrathecal therapy alone is, as in the case of CNS disease in ALL (26),
probably inadequate.
In patients with initial CNS involvement, especially those in whom there is
also marrow infiltration or B-cell ALL, the outcome of massive therapy with
chemotherapy alone has been relatively disappointing. There is, therefore, a
need to evaluate the addition of irradiation in such cases, possibly with a
subsequent randomization against BEAM alone.
The use of double autologous grafts has been investigated (27), but
because of the rapid cell turnover time of Burkitt's lymphoma, only a single
graft is possible in most cases. However, for patients with resistant relapse, we
are currently studying the use of BEAM followed after 7-10 days with cyclophosphamide,
TBI, and reinfusion of marrow.
We review here our 6 years' experience with massive therapy and ABMT
for Burkitt's lymphoma. When we initiated this program, overall survival in
Lyons by conventional chemotherapy was 42%, and CNS relapse was the
major problem (2,3). In addition, with regard to ABMT, a purging procedure
was not ready for clinical use. Now overall survival in Lyons with a
conventional regimen is 77% (28), and CNS relapse is a rare event in Burkitt's
lymphoma (