Autologous Bone Marrow Transplantation - Blog Science Connections

260 ABMTin Burkitts Lymphoma
restricted to 20% of patients who should be divided in two groups according to
therapy response. Massive therapy and ABMT are currently the best
treatment for Burkitt's lymphoma in PR after initial induction therapy or in
responding relapse after rescue protocols. The only question that remains
unanswered is whether the high efficacy of second-line rescue protocols will
still be observed when relapses follow more aggressive initial therapy.
Massive therapy and ABMT are still experimental treatment for patients with
Burkitt's lymphoma who have initial CNS involvement, patients for whom
results remain disappointing with conventional regimens (29).
Massive therapy, such as BACT or BEAM, are clearly not able to cure
patients with progressive disease (33). For this group of patients new phase 11
studies are urgently needed and should be set up as a multicenter cooperative
trial. These studies could be based on conventional chemotherapy regimens
tested with ABMT to determine if a dose-effect relationship can improve the
results. New massive therapy combinations, including high-dose cisplatin,
melphalan, ifosfamide, carmustine, cytarabine, and high-dose methotrexate,
should be explored. Combinations of various alkylating agents as proposed
by the Baltimore group may be a useful avenue to explore (23). The role of
TBI remains unclear in Burkitt's lymphoma, despite poor results reported in
other lymphomas (24). However, it is clear that such phase II studies will be
the basis of any future progress in Burkitt's lymphoma, either in conventional
or massive therapy regimens.
ACKNOWLEDGMENT
We thank Z. Abdelbost for her technical assistance.
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