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Autologous Bone Marrow Transplantation - Blog Science Connections

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Optimum Timing of <strong>Autologous</strong> <strong>Bone</strong> <strong>Marrow</strong><br />

<strong>Transplantation</strong> for Patients With Large<br />

B-Cell Lymphoma<br />

Subhash C. Gulati, Brenda Shank, Pat Black, James Yopp,<br />

Benjamin Koziner, David Straus, Hugo Castro-Malaspina,<br />

Isabel Cunningham, Morton Coleman, Jens Atzpodlen,<br />

Kee Shum, Jon Kwon, Chihiro Shimazaki,<br />

O. Michael Colvin, Zvi Fuks,<br />

Richard O'Reilly, and<br />

Bayard Clarkson<br />

Recent combination chemotherapy protocols have improved the survival<br />

rates for patients with non-Hodgkin's lymphoma. Extended long-term<br />

disease-free survival was first reported with MOPP (mechlorethamine, Oncovin<br />

[vincristine], procarbazine, prednisone) or C-MOPP (MOPP plus cyclophosphamide)<br />

(1). Subsequently, most protocols have used regimens that<br />

contain Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), and vincristine<br />

(CHOP, CHOP-Bleo, BACOP, ACOMLA). These protocols have produced<br />

a complete remission (CR) incidence of 40-70%, but a significant<br />

number of patients relapse (2-6). Newer regimens, including ProMACE-MOPP<br />

(7), COP-BLAM (8,9), M-BACOD (10), m-BACOD (11), and MACOP-B<br />

(methotrexate + Leucovorin rescue, Adriamycin [doxorubicin]) (12), have<br />

279

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