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We report three patients with lethal forms of acute GVHD in whom all biopsy specimens showed a striking preponderance of macrophages in the inflammatory infiltrate with production of TNF-alpha. The role of the macrophage/TNF-alpha axis in human acute GVHD is examined and the existence of primary macrophagic forms of GVHD is discussed.

In contrast to intermediate- and high-grade non-Hodgkin's lymph-omas (NHL), patients with follicular lymphomas retain a poor prognosis in the long run. Several reports suggested that they are incurable by conventional chemotherapy. 10 patients with follicular NHL were autografted for consolidation of early remission. One of these patients treated in 1979 received the TACC regimen with unpurged marrow. The other 9 (8 in first, 1 in second remission) treated since July 1987 received the BEAM regimen followed by autologous bone marrow transplantation (ABMT) with marrow purged in vitro by mafosfamide at levels individually adjusted. There were no toxic deaths. 8 patients remain in unmaintained CR 15 to 43 months post-ABMT - 2 are beyond 2 years. The patient autografted in 1979 has relapsed 9 yr later. ABMT is feasible with no indue toxicity for consolidation of follicular NHL early in first remission, as an alternative aggressive strategy. Further studies and a longer follow-up will be needed to evaluate its antitumor efficacy.

Seventy eight patients were systematically studied for thyroid function after bone marrow transplantation. We observed a slight increase of TSH in sixteen cases, on case of patent hypothyroidism, and four cases of hyperthyroidism. Characteristics of these thyroid dysfunctions are described.