High-dose therapy followed by bone marrow transplantation for relapsed follicular non-Hodgkin's lymphoma

Purpose: To analyze whether, in addition to survival, and disease-free survival progression-free interval after transplantation would be longer than the last progression-free interval before transplantation, supporting the argument that high-dose therapy may change the biologic behavior of the disease.

Patients and Methods: Patients with a poor-risk relapsed follicular NHL were treated with three cycles of doxorubicin 50 mg/m(2) and teniposide 60 mg/m(2), followed by etoposide 350 mg/m(2), cyclophosphamide 60 mg/kg, and TBI and unpurged BMT.

Results: Twelve patients were entered in the study. Ten patients fulfilled the criteria for response and underwent transplantation, two of them with an allograft. Nine of ten patients with transplants achieved a complete remission after BMT. One patient died on day 41 due to veno-occlusive disease. The nine patients with transplants who were evaluable for follow-up had a conversion of remission or response duration after transplantation, their progression-free interval after BMT being superior to the last one before BMT with a median of 1044+ days. Overall survival and disease-free survival in the transplant patients after a median follow-up of 1160 days from BMT is 90%.

Conclusion: High dose chemotherapy followed by stem cell rescue may change the clinical course in follicular non-Hodgkin's lymphoma patients.