Autologous Bone Marrow Transplantation - Blog Science Connections

International Randomized Trial in Non-Hodgkin's
Lymphoma in Relapse
F. Chauvin, A. Leizorovicz, Y. Alamercery, C. Lasset, Z. Abdelbost,
and T. Philip
For a decade, high-dose chemotherapy with autologous bone marrow transplantation
(ABMT) has been used as salvage therapy in non-Hodgkin's
lymphoma at relapse to increase the response and survival rates using the
dose-effect relationship. In the same way, conventional regimens have been
administered and a good response rate observed with acceptable toxicity.
The results of high-dose therapy with ABMT (30% of patients surviving free of
disease at 2 years) seem better than those obtained with conventional therapy
(5-10% surviving free of disease at 2 years). However, it is obvious that the
ABMT group is carefully selected and exclusive and not comparable with
groups that include all patients who relapse, the typical organization of
groups in conventional therapy studies. Although these two therapeutic
strategies are equally used, their efficacies and toxicities have never been
compared properly in a randomized clinical trial. Now this comparison is
slated to be the objective of a phase III international randomized trial. In such
a trial, several steps must be carefully considered by methodologists and
statisticians; selection of patients, method of randomization, and method of
evaluations can cause biases and invalidate results.
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