IMVP-16 followed by high dose chemotherapy and autologous bone marrow transplantation as salvage treatment for malignant lymphoma.

Thirty patients with high-grade malignant lymphoma were treated with ifosfamide-VP16213-methotrexate (IMVP-16) combination chemotherapy after failing to respond completely or after relapsing on CHOP-like therapy. Responders to the salvage therapy subsequently were treated with ablative chemotherapy (BCNU, VP16213, Ara-C and melphalan) and autografted. Of these 30 patients 11 were in relapse, 11 were partial responders and eight failed CHOP-like therapy. There were eight complete remissions and 12 partial responses to IMVP-16. These 20 patients were transplanted, together with one nonresponder. Ten of these 21 patients are disease-free survivors 16 to 76 months (median 32) after autografting. There were three treatment-related deaths: one before and two during the autografting procedure. Using one of the best salvage therapy combinations followed by high dose chemotherapy and autografting is feasible. The results of this study suggest that an appreciable number of patients may be cured by this procedure.