High-dose Chemotherapy With Autologous Peripheral Blood Stem Cell Transplantation For Advanced And Recurrent Lymphomas

Lymphomas are a group of hematopoietic malignant disease, originated in lymph node or any organ of body, which presents 4 pecent of all cancer-related deaths. Lymphomas include Hodgkin's Disease ( HD) and Non -Hodgkin's Lymphoma (NHL). The mortality of Malignant lymphoma is 115 every one hundred thousand, which deeply endangered people'health . lymphomas are sensitive to chemotherapy or radiotherapy. Traditional treatment may radically cure 60 pecent of HD or 30-50 pecent of NHL. Nevertheless,the advanced and recurrent lymphomas have poor prognosis .In recent years, high-dose chemotherapy with autologous peripheral blood stem cell transplantation (APBSCT) showed preferablecurative effect. To evaluate the efficacy of high-dose chemotherapy with APBSCT in advanced and recurrent lymphomas, and to evaluate the efficacy of tandem autotransplant,as well as Rituximab, in advanced lymphoma,we adopted high-dose chemotherapy with APBSCT for advanced and recurrent lymphomas.1. ObjectiveTo evaluate the efficacy of high-dose chemotherapy with autologous peripheral blood stem cell transplantation in advanced and recurrent lymphoma , and to evaluate the efficacy of tandem autotransplant,as well as Rituximab, in advanced lymphomas.2. Materials and Methods2.1 PatientsTen patients with advanced and recurrent lymphomas, including 9 NHL and 1 HD, received high-dose chemotherapy with autologous peripheral blood stem cell transplantation in our hospital between October 1999 and May 2003.2.2 MethodsMobilization regimen was CHOPE/CHOP with G-CSF , The conditioning regimen for the tandem autologous transplantation was high-dose CHOPE.The other 5 patients received one time autologous transplantation with the conditioning regimen of CHOPE or BEAM . Two patients used rituximab to eliminate minimal residual disease.2.3 StatisticsSPSS 11.0 system for statistics analyse.Continuous variables were compared by median of the Independent-Samples T Test. Kaplan-Meier estimates were used to describe survival. Data present as Median(range,minimum-maximum). 3. ResultsAll patients after autologous peripheral blood stem cell transplantation achieved prompt and sustained hematopoietic reconstitution. The median period to gain absolute neutrophil count to 0.5×l0~9/L or above was 11days (range ,8 to 13d),and that for platelet count to 2.0×10~9/L or above was 11 days (range, 5 to 30d).The medium follow-up duration was 22 (8-85)months. The overall survival(OS) at 1 year and 3 year were (91.3±8.1) % and (44.4±18.8) %,respectively. The disease-free survival(DFS) at 1 year and 2 year were (55.6±16.5)% and (41.7±17.2) %,respectively. Tandem autotransplant,as well as rituximab, in advanced lymphomas showed preferable curative effect. 4.ConclusionsThe method of high-dose chemotherapy with autologous peripheral blood stem cell transplantation for advanced and recurrent lymphomas is a safe and effective modality.