Autologous Bone Marrow Transplantation - Blog Science Connections

Proposed International Adult Lymphoma Study 315
Qoldstone (4) later concluded that no statistically significant difference was
observed in outcome between adults and children (Fig 2) or between patients
with Burkitt's and those with non-Burkitt's lymphoma (Fig 3). The concept of
RR and NRR has been subsequently confirmed in 1 ) a review of 42 cases in
France of Burkitt's lymphoma (Fig 4) (5); 2) a review of 42 cases of adult
diffuse lymphoma from France and England (Fig 5) (3); and 3) a review of 39
patients with non-Hodgkin's lymphoma from Houston and Omaha (Fig 6;
Table 1 ) (6). In addition, in 1986 data from bone marrow transplantation
centers in Europe and the United States were pooled to determine the
outcome of ABMT in adult patients with relapsed diffuse intermediate- or
high-grade non-Hodgkin's lymphoma (excluding those with Burkitt's lymphoma)
and to identify the prognostic significance of response to therapy
preceding the bone marrow transplant procedure. One hundred patients
were treated with high-dose chemotherapy alone (61 patients) or high-dose
chemotherapy plus total body irradiation (TBI) (39 patients). The median age
was 35 years and the median Karnofsky performance score was 80%. Thirtyfour
patients had disease that was primarily refractory to chemotherapy (they
never achieved CR) and had progressive disease. Sixty-six patients achieved
CR with primary chemotherapy but later relapsed. After receiving further
(salvage) chemotherapy at traditional doses, 22 patients had no response or
disease progression (i.e., RR), and 44 patients had PRs or CRs after salvage
chemotherapy (SR).
" " '
1 1
H i l l
-I ADULTS (52)
— 1 ALL (112)
-'CHILDREN (60)
71
19
MONTHS
S2
ss
Figure 2. Disease-free survival of children and adults with non-Hodgkin's lymphoma who
underwent autologous bone marrow transplantation in a European Bone Marrow Transplantation
Group trial (data compiled January 1984). Reprinted, by permission, from
Goldstone (4).