[Combined high dose chemotherapy with autologous stem cell transplantation and total body radiotherapy for 32 malignant lymphoma patients].

Objective: To evaluate the effect of high dose chemotherapy with or without total body irradiation (TBI) supported by autologous hematopoietic stem cell transplantation (AHSCT) for malignant lymphoma.
Methods: From June 1991 to April 2000, 32 malignant lymphoma (ML) patients were treated with AHSCT. Their ages ranged from 19 to 52 years (median 37). There were 23 non-Hodgkin's lymphoma (NHL) and 9 Hodgkin's lymphom (HD). Twelve patients received autologous bone marrow transplantation (ABMT) and 20 patients received autologous peripheral blood stem cell transplantation (APBSCT). In the latter, the mobilization plan was carboplatin and etoposide (CE) or CHOP (CTX, ADM, VCR, PDN) plus G/GM-CSF 10 micrograms/kg/d in high dose chemotherapy. BEAM (BCNU, Vp-16, AraC, MEL) or MEL 140 mg/m2 + Vp-16 200 mg + total body irradiation (TBI) 8 Gy.
Results: Up to May 2000, hematopoietic reconstitution was reestabished in 100% (32/32) patients after AHSCT, with median follow-up of 1,020 days (40-3,240). The 1- and 2-year disease-free survivals (DFS) were 78.1%(25/32) and 46.9% (15/32) with the longest survival of 8 years. Even though eight patients have developed relapse, there is no transplantation-related death.
Conclusion: High dose chemotherapy and radiotherapy supported by autologous hematopoietic stem cell transplantation (AHSCT) for high risk, relapsed or sensitive ML, being highly efficient, should be the first indication. It is better than the standard conventional treatment. The hematopoietic reconstitution of autologous peripheral blood stem cell transplantation (APBSCT) is quicker than autologous bone marrow transplantation (ABMT). No significant difference between chemotherapy alone and chemotherapy plus total body irradiation is observed.