BACKGROUND: We analysed data on patients of Hodgkin and non-Hodgkin lymphoma treated with high dose chemotherapy followed by autologous stem cell transplantation to determine the toxicity, pattern of infections and long-term outcome. METHODS: There were 34 male and 10 female patients (median age 35 years, range 15-67 years). Before transplantation, 31 patients (70.5%) had chemosensitive disease and 13 (29.5%) had chemoresistant disease. Granulocyte-colony stimulating factor mobilized peripheral blood stem cells were used as the source of stem cells. The patients received high dose chemotherapy using CBV (cyclophosphamide, BCNU and VP16 [etoposide] n = 38), BEAM (BCNU, etoposide, cytosine arabinoside and melphalan, n = 3), cytosine arabinoside, etoposide and melphalan (n = 2) and melphalan alone (n = 1). Prophylaxis with antifungal drugs (fluconazole/itraconazole) and acyclovir was used. RESULTS: Following transplant, 32 patients (72.7%) responded; complete response was achieved in 25 patients (56.8%) and partial response in 7 (15.9%). The rate of complete response was higher for patients with pre-transplant chemosensitive disease (23/31 [74.2%] v. 2/13 [15.4%], p < 0.001). Gastrointestinal toxicity, and renal and liver dysfunctions were major non-haematological toxicities; 3 patients (7%) died of regimen-related toxicity. Infections (predominantly Gram-negative) accounted for 2 deaths (4.5%) seen before day 30. At a median follow up of 79 months (range 14-168 months), median overall and event-free survival were 78 months and 28 months, respectively. Estimated mean (SE) overall and event-free survival at 60 months were 54.34% (0.07) and 34.3% (9.88), respectively. CONCLUSION: Patients with pre-transplant chemosensitive disease and those who achieved complete response following transplant had a significantly better chance of survival.
BACKGROUND: We analysed data on patients of Hodgkin and non-Hodgkin lymphoma treated with high dose chemotherapy followed by autologous stem cell transplantation to determine the toxicity, pattern of infections and long-term outcome. METHODS: There were 34 male and 10 female patients (median age 35 years, range 15-67 years). Before transplantation, 31 patients (70.5%) had chemosensitive disease and 13 (29.5%) had chemoresistant disease. Granulocyte-colony stimulating factor mobilized peripheral blood stem cells were used as the source of stem cells. The patients received high dose chemotherapy using CBV (cyclophosphamide, BCNU and VP16 [etoposide] n = 38), BEAM (BCNU, etoposide, cytosine arabinoside and melphalan, n = 3), cytosine arabinoside, etoposide and melphalan (n = 2) and melphalan alone (n = 1). Prophylaxis with antifungal drugs (fluconazole/itraconazole) and acyclovir was used. RESULTS: Following transplant, 32 patients (72.7%) responded; complete response was achieved in 25 patients (56.8%) and partial response in 7 (15.9%). The rate of complete response was higher for patients with pre-transplant chemosensitive disease (23/31 [74.2%] v. 2/13 [15.4%], p < 0.001). Gastrointestinal toxicity, and renal and liver dysfunctions were major non-haematological toxicities; 3 patients (7%) died of regimen-related toxicity. Infections (predominantly Gram-negative) accounted for 2 deaths (4.5%) seen before day 30. At a median follow up of 79 months (range 14-168 months), median overall and event-free survival were 78 months and 28 months, respectively. Estimated mean (SE) overall and event-free survival at 60 months were 54.34% (0.07) and 34.3% (9.88), respectively. CONCLUSION:Patients with pre-transplant chemosensitive disease and those who achieved complete response following transplant had a significantly better chance of survival.