Treatment of patients with relapsed and resistant non-Hodgkin's lymphoma using total body irradiation, etoposide, and cyclophosphamide and autologous bone marrow transplantation Journal Article
| Authors: | Gulati, S.; Yahalom, J.; Acaba, L.; Reich, L.; Motzer, R.; Crown, J.; Toia, M.; Igarashi, T.; Lemoli, R.; Hanninen, E.; Doherty, M. |
| Article Title: | Treatment of patients with relapsed and resistant non-Hodgkin's lymphoma using total body irradiation, etoposide, and cyclophosphamide and autologous bone marrow transplantation |
| Abstract: | Purpose: Patients with non-Hodgkin's lymphoma (NHL) who do not achieve a complete response (CR) after induction chemotherapy or who relapse after achieving a CR are rarely cured of their disease by the usual salvage therapy. Success of high-dose cytotoxic therapy with an autologous bone marrow transplant (AuBMT) is limited. We describe the results of a prospective single-institution study using a new conditioning regimen for patients with relapsed or resistant NHL who underwent AuBMT. Patients and Methods: Forty-four patients were reinduced with cytotoxic therapy and then evaluated for response. All patients received the conditioning regimen of hyperfractionated total body irradiation (TBI), etoposide (VP-16), and cyclophosphamide (CTX) followed by autologous bone marrow reinfusion. Results: The disease-free survival (DFS) rate was 57% with a median follow-up of 42+ months. The only variable significantly associated with DFS was the patient's remission status at AuBMT. Patients who underwent AuBMT in CR had a DFS of 80%, whereas patients who underwent AuBMT in partial response (PR) or with progressive disease (PD) had a DFS of 60% and 11%, respectively (P = .002). The major toxicity was hemorrhage at the she of bulky disease, especially in patients with residual mediastinal and/or pulmonary disease. Conclusion: Planned reinduction cytotoxic therapy followed by TBI, VP-16, and CTX with AuBMT is an effective treatment for patients with relapsed and resistant NHL. © 1992 by American Society of Clinical Oncology. |
| Keywords: | adult; cancer chemotherapy; cancer survival; clinical article; survival rate; cancer recurrence; cancer growth; combined modality therapy; follow up; etoposide; bleeding; antineoplastic combined chemotherapy protocols; recurrence; cyclophosphamide; radiation injury; patient care; cancer regression; nonhodgkin lymphoma; whole body radiation; lymphoma, non-hodgkin; bone marrow transplantation; transplantation, autologous; whole-body irradiation; autologous bone marrow transplantation; middle age; human; male; female; priority journal; article; support, non-u.s. gov't |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 10 |
| Issue: | 6 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1992-06-01 |
| Start Page: | 936 |
| End Page: | 941 |
| Language: | English |
| DOI: | 10.1200/jco.1992.10.6.936 |
| PUBMED: | 1588372 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 30 July 2019 -- Source: Scopus |
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