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[Successful double peripheral blood stem cell transplantation for patient with malignant lymphoma of primary
1Third Department of Internal Medicine, Kyoto First Red Cross Hospital.
Abstract:
Three patients with non-Hodgkin's lymphoma of intermediate-grade histologies, who had failed to achieve a complete remission (CR) after more than several courses of conventional chemotherapy were treated with two cycles of high-dose chemotherapy with autologous peripheral blood stem cell transplantation (double PBSCT). All patients received regimen A with carboplatin 1g/m2, etoposide 1.2g/m2 and cyclophosphamide 120mg/kg prior to 1st PBSCT and obtained a partial remission. One patients received regimen A and two patients received regimen B with MCNU 500mg/m2, etoposide 750mg/m2 and L-PAM 140mg/m2 prior to 2nd PBSCT and all patients obtained CR. Second PBSCT was performed 3 to 5 months after the 1st PBSCT. At a median follow-up of 36 (range; 29 to 54) months, all patients remained in continuous CR. The period after reinfusion of PBSCT to achieve a neutrophil count more than 500/microliters ranged between 7 and 9 days and to achieve a platelet count more than 5 x 10(4)/microliters ranged 12 and 22 days. Grade 3 nonhematologic toxicity (mucositis) was seen in one patient after 2nd PBSCT. Double PBSCT could be well tolerated with a high response rate in patients with malignant lymphoma of primary induction failure.