Role of high-dose chemotherapy with hemopoietic stem cell transplantation in patients with non-Hodgkin's lymphomas

Abstract

High-dose chemotherapy (HDC) with autologous or allogenic hemopoietic stem cell transplantation (SCT) is successfully used in refractory, relapsed or high-risk primary aggressive non-Hodgkin's lymphomas (NHL). Results on HDC employing in follicular lymphoma, is inconclusive. Recent studies has suggested that com- bining of anti-CD20 (rituximab) with HDC (HDC-R) may successfully eliminate minimal residual disease, further delaying or preventing disease relapse and potentially extending the duration of survival after autologous SCT in patient with aggressive B-cell lymphomas. The paper discusses recent dates on HDC-R treatment strategy and presents the author's own data on the use of HDC with autologous SCT in a group of 50 patients with relapsed and primary resistant NHL (22 of them received rituximab at different stages of treatment - remission induction, stem cell collection, posttransplantation period). In all patients receiving high- dose therapy, 5-year overall survival was 40.3% and 5-year relapse-free survival was 77.5%. 5-year overall survival was 52% in patients with the B-cell pheno- type treated with HDC plus rituximab, and 21% in those treated with HDC only (p = 0.014). Treatment toxicity was comparable in both groups.

Keywords

• non-hodgkin's lymphomas
• high-dose chemotherapy
• hemopoietic stem cell transplantation
• rituximab