Journal of Clinical Oncology, Vol 12, 1358-1365, Copyright © 1994 by American Society of Clinical Oncology
High-dose therapy and autologous bone marrow transplantation for adult patients with lymphoblastic lymphoma: results of the European Group for Bone Marrow Transplantation
JW Sweetenham, G Liberti, R Pearce, G Taghipour, G Santini and AH Goldstone
Cancer Research Campaign, Wessex Medical Oncology Unit, University of Southampton, Southampton General Hospital, United Kingdom.
PURPOSE: To investigate the results of treatment and factors that affect
prognosis in adult patients undergoing high-dose therapy and autologous
bone marrow transplantation (ABMT) for lymphoblastic lymphoma (LBL).
PATIENTS AND METHODS: The study was a retrospective analysis of 214
patients reported to the Lymphoma Registry of the European Group for Bone
Marrow Transplantation (EBMT) between January 1981 and December 1992,
including 105 patients undergoing marrow transplantation in first complete
remission (CR). Data on all patients were reviewed, and analysis of
prognostic factors conducted. RESULTS: The actuarial overall survival rate
at 6 years for the entire group is 42%. Disease status at ABMT was the
major determinant of outcome: 6- year actuarial overall survival was 63%
for patients transplanted in first CR, compared with 15% for those with
resistant disease at the time of transplantation. Transplantation in second
CR resulted in a 31% rate of actuarial overall survival at 6 years. For
patients transplanted in first CR, univariate analysis failed to identify
any factors at presentation that predicted for outcome after
transplantation. CONCLUSION: These results suggest that ABMT is effective
therapy for adults with LBL, even in patients with disease that is
resistant to conventional-dose therapy. Results for patients transplanted
in second CR are superior to those reported for conventional-dose salvage
regimens. The results in first CR require verification in a prospective
randomized clinical study.
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