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BEAM CHEMOTHERAPY AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR PATIENTS WITH RELAPSED OR REFRACTORY NON-HODGKINS-LYMPHOMA

MILLS, W; CHOPRA, R; MCMILLAN, A; PEARCE, R; LINCH, DC; GOLDSTONE, AH; (1995) BEAM CHEMOTHERAPY AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR PATIENTS WITH RELAPSED OR REFRACTORY NON-HODGKINS-LYMPHOMA. J CLIN ONCOL , 13 (3) 588 - 595.

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Abstract

Purpose: To evaluate the outcome of patients with relapsed or resistant non-Hodgkin's lymphoma (NHL) undergoing high-dose chemotherapy and autologous bone marrow transplantation (ABMT) and to determine the main prognostic factors.Patients and Methods: One hundred seven patients with relapsed or resistant intermediate-/high-grade NHL underwent high-dose carmustine, etoposide, cytarabine, and melphalan (BEAM) chemotherapy and ABMT at University College Hospitals between September 1981 and February 1993. The minimum follow-up duration of all patients is 6 months.Results: At 3 months, the overall response rate to BEAM and ABMT was 73% (41% complete response and 32% partial response). The 5-year actuarial overall survival and progression free survival rates were 41% and 35%, respectively. The early procedure-related mortality rate was 7% (eight of 107 patients). On multivariate analysis, the main prognostic factor was disease status at the time of ABMT. Patients with chemosensitive disease had on actuarial 5-year survival rate of 49% at 5 years compared with 13% for those with chemoresistant disease (P < .001). For patients considered to have chemosensitive disease at the time of transplantation, there is a significant difference in the actuarial progression-free survival rates for those who received high-dose therapy after attaining a partial response to first-line therapy (69% at 5 years) os compared with those with sensitive but relapsed disease (32% at 5 years) (P = .003).Conclusion: Patients with chemosensitive disease benefit most from high-dose chemotherapy, and those who receive such therapy early after achieving a partial response to first-line therapy have a high rate of cure. (C) 1995 by American Society of Clinical Oncology.

Type: Article
Title: BEAM CHEMOTHERAPY AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR PATIENTS WITH RELAPSED OR REFRACTORY NON-HODGKINS-LYMPHOMA
Keywords: HIGH-DOSE THERAPY, SALVAGE THERAPY, COMBINATION, FAILURE, GRADE
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: http://discovery.ucl.ac.uk/id/eprint/144727
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