Clinical trial of intensive therapy and autologous bone marrow transplantation in the treatment of malignant diseases.

Fifteen patients with advanced or resistant non-Hodgkin's lymphoma or solid tumors were treated with marrow-lethal intensive therapy followed by autologous bone marrow transplantation. Seven of the patients are still alive 7.5-48.5 mo after transplantation; four of them are surviving in complete remission more than 3 yr after transplantation. Treatment failures were due to relapse, in four patients, resistance to the treatment in two and fatal complications in five. The fatal complications were non-marrow toxicity due to overdoses in two patients. and interstitial pneumonia in three. Relapse is one of the major problems to be solved in autologous marrow transplantation. When our data were analyzed in relation to relapse after transplantation, the factors responsible for relapse were found to include 1) tumor burden before transplantation, 2) therapeutic effectiveness of the conditioning regimen, and 3) contamination of cryopreserved marrow with tumor cells. Our data indicate that the combination of intensive therapy and autologous marrow transplantation will be the treatment of choice with acceptable risks for selected patients with advanced or resistant malignant disease with a poor prognosis and that it can produce remission in a substantial proportion of these patients.