Abstract

Patients with intermediate or high-grade non-Hodgkin's lymphoma(NHL) have been reported a 40% to 70% cure rate when treated with conventional chemotherapy or radiotherapy. However, most of the patients who do not attain complete remission(CR) or who relapae after chemotherapy are incurable using conventional salvage therapies and these individuals have potential for cure with high-dose therapy with reinfusion of stem cells derived from bone marrow or peripheral blood. Between February 1993 and September 1995, 26 patients with aggressive, relapsed and/or refractory malignant lymphoma were treated with high-dose chemotherapy with either autologous peripheral blood stem cell(25 patients) or bone marrow(l patient) support in 7 university hospitals in Korea. The median age was 39 years(range, l7 to 69) and male to female ratio was 4.2: 1. The common histologic types were diffuse large cell(42%), immunoblastic type(15%) of non-Hodgkin's lymphoma. The rate of complete remission was 61%(14/23) and overall remission rate was 78%(18/ 23) for the patients with measurable disease. Three patients were treated as the consolidation therapy in the status of complete remission. The median duration of remission was not reached right now. The median survival time was 7.8 months for all patients(the median follow up time; 9 months). The median time to recovery to a neutrophil count more than 0.5 x 10(9)/L was 13 days(range, 8 to 43), and to 1 x 10(9)/L was 22 days(range, 8 to 53). The median time to recovery of platelet count more than 50 x l0(9)/L and 100 x 10(9)/L were 20 days(range, 8 to 45) and 21 days(ranae, ll to 60). Non-hematologic side effects were fever, nausea and vomiting, and liver toxicity. Two toxic deaths occurred due to cardiovascular disease, mainly congestive heart failure. Based on high complete remission rate and tolerable toxicity, high-dose chemotherapy with hematopietic stem cell support appears to be a promising treatment modality for the patients with aggressive, relapsed and/or refractory malignant lymphoma.

• Keywords: Malignant lymphoma, High-dose chemotherapy, Hematopoietic stem cell support