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Autologous Bone Marrow Transplantation in Heavily Pretreated and Resistant Patients with Malignant Lymphomas

During the period from October 1993 to January 1996, 13 patients with malignant lymphoma, heavily pretreated with active disease, were included in autologous bone marrow and peripheral blood stem cells transplantation program at the Clinical Hospital "Merkur". The group consisted of 7 patients with Non-Hodgkin's lymphoma (NHL) and 6 with Hodgkin's lymphoma (MH). There were 9 male and 4 female patients with a median age of 26 (range, 17) years. All patients underwent bone marrow harvest, in 6 patients together with peripheral blood stem cell collection (PBSC) in order to obtain sufficient number of CD34+ cells. All 6 patients included in the PBSC program received high-dose cyclophosphamide regimens for mobilization of CD34+ cells. The median number of collected CD34+ cells was 1.76 x 10Č6/kg body weight (range, 1.05-10.67), and mononuclear cells 1.83 x 10Č8/kg body weight (range, 0.15-3.74) per kg of body weight. Immunophenotyping of CD34+ cells was performed on Coulter Profile II device. As a conditioning therapy we applied BEAM in all patients. All patients, except one, received hemopoietic growth factors (G-CSF, GM-CSF). The median number of days on GF was 11 (range, 0). Leukocyte count over 1 x 10Č9/L was observed on the day 14 (median ; range 9) after the reinfusion, absolute neutrophil count reached 0.5 x 10Č9/L on the day 14 (median ; range 9) and platelet count over 20 x 10Č9/L on the day 16 (median ; range 13). The median number of febrile days was 2 (range, 1), and days of IV antibiotic administration 10 (range, 7). After reinfusion of autografts, patients were given 18 doses of platelets (median ; range 6) and red blood cells concentrate 720 ml (median ; range 0). Significant correlation wasn't observed between the number of reinfused MNC, CD34+ cells and the duration of pancytopenia. The median follow up period is 10 (range, 2-28) months. Nine patients are still in complete remission, and 4 patients relapsed, 1 of them never achieved CR. We conclude that the method of autologous bone marrow transplantation is safe in highly pretreated patients with malignant lymphomas and the results are promising and comparable with the results from the other centers.

autologous bone marrow transplantation; lymphoma

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