We have conducted a pilot study to investigate the role of high-dose therapy and autologous bone marrow/stem cell transplantation (ASCT) during first complete or partial remission in 52 @entity1 with poor-risk aggressive @entity706 . There were 42 @entity1 with intermediate-grade or @entity706 who were considered to be high (60%) and high-intermediate risk (40%) groups at diagnosis based on the age-adjusted International Prognostic Index (IPI) and 10 @entity1 with high-grade, @entity1893 ( @entity1893 , Burkitt's, and non-Burkitt's), who at presentation had poor-risk features defined as elevated serum @entity880 dehydrogenase level, stage IV, and bulky mass >/=10 cm. The median age was 34 years (range, 16 to 56 years). Thirty-nine were transplanted in first complete remission and 13 in first partial remission after conventional therapy. Conditioning regimens consisted of @entity348 ( @entity348 ) administered as a single fraction 750 cGy in 3 @entity1 and in fractionated doses for a total of 1,200 cGy in 44 @entity1 , in combination with 60 mg/kg @entity2879 and 100 mg/kg @entity786 . Five @entity1 with prior radiotherapy received 450 mg/m2 carmustine instead of @entity348 . Stem cell sources were either @entity236 . No in vitro purging was used. All @entity1 engrafted. Two @entity1893 @entity1 died of @entity5885 at 25 days and @entity3052 at 27 months posttransplantation. There were six relapses at 1.5 to 12.8 months posttransplantation. At a median follow-up of 44 months (range, 1 to 113 months), the estimated 3-year overall survival (OS) and disease-free survival (DFS) for all @entity1 was 84% (95% confidence interval [CI], 70% to 92%) and 82% (95% CI, 68% to 91%), respectively. In the subset of @entity1 with intermediate-grade and @entity706 , the 3-year DFS was 89% (95% CI, 74% to 96%) for all @entity1 , 87% (95% CI, 67% to 96%) for high-risk @entity1 , and 92% (95 CI, 61% to 99%) for high-intermediate risk @entity1 . The 3-year OS and DFS for @entity1893 @entity1 were identical at 60% (95% CI, 30% to 84%). These results suggest that high-dose therapy and ASCT during first remission may improve the survival and prognosis of @entity1 with poor-risk intermediate- and high-grade @entity706 . A prospective randomized study comparing high-dose therapy and ASCT with conventional chemotherapy in IPI high-risk @entity1 with aggressive @entity1893 should be undertaken.

Results of high-dose therapy and autologous bone marrow/stem cell transplantation during remission in poor-risk intermediate- and high-grade XXXX : international index high and high-intermediate risk group.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity706 :: ('MESH:D008223', 'Disease') :: ['lymphoma', 'immunoblastic lymphoma'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity3052 :: ('MESH:D015470', 'Disease') :: ['acute leukemia'] @entity5885 :: ('MESH:D011668', 'Disease') :: ['venoocclusive disease'] @entity348 :: ('MESH:C535338', 'Disease') :: ['TBI', 'total body irradiation'] @entity880 :: ('MESH:D019344', 'Chemical') :: ['lactate'] @entity1893 :: ('MESH:D008228', 'Disease') :: ["non-Hodgkin's lymphoma", 'small non-cleaved cell', 'SNCCL'] @entity236 :: ('MESH:D001855', 'Disease') :: ['bone marrow and/or peripheral blood']
@entity706 :: (MESH:D008223,Disease) :: ['lymphoma']
