1. Long-Term Follow-Up of Autologous Bone Marrow Transplantation in Patients With Relapsed Follicular Lymphoma
- Author
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Robert Schlossman, John G. Gribben, Donna Neuberg, David C. Fisher, Jerome Ritz, Peter Mauch, Haddy Jallow, Robert J. Soiffer, Tak Takvorian, Kenneth C. Anderson, Edwin P. Alyea, Lee M. Nadler, Caroline Kuhlman, and Arnold S. Freedman
- Subjects
medicine.medical_specialty ,Cyclophosphamide ,business.industry ,Immunology ,Follicular lymphoma ,Cell Biology ,Hematology ,Total body irradiation ,medicine.disease ,Biochemistry ,Gastroenterology ,Surgery ,Transplantation ,Regimen ,medicine.anatomical_structure ,Internal medicine ,medicine ,Bone marrow ,business ,Chemoradiotherapy ,Survival analysis ,medicine.drug - Abstract
We report the results of high-dose chemoradiotherapy and anti–B-cell monoclonal antibody-purged autologous bone marrow transplantation (ABMT) in patients with relapsed indolent follicular lymphoma. Between March 1985 and May 1995, 153 patients underwent ABMT using a uniform ablative regimen with cyclophosphamide and total body irradiation and bone marrow (BM) purging. All patients received multiple chemotherapy regimens before ABMT. At BM harvest, only 30% of patients were in complete remission, and overt BM infiltration was present in 47%. The disease-free survival (DFS) and overall survival (OS) are estimated to be 42% and 66% at 8 years, respectively. Patients whose BM was negative by polymerase chain reaction (PCR) for bcl2/IgH rearrangement after purging experienced longer freedom from recurrence than those whose BM remained PCR positive (P < .0001). Continued PCR negativity in follow-up BM samples was also strongly predictive of continued complete remission (CR). The 12-year survival from diagnosis for these 153 patients is 69%. Considering that the median survival from diagnosis and first recurrence of patients with advanced follicular lymphoma are 8 and 5 years, respectively, our results provide evidence that myeloablative therapy and ABMT may prolong overall survival.
- Published
- 1999
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