Autologous bone marrow transplantation for Hodgkin's disease and non-Hodgkin's lymphoma.


Autologous bone marrow transplantation has curative potential in patients with both Hodgkin's disease and non-Hodgkin's lymphoma who have relapsed following conventional therapy. Autologous bone marrow transplantation allows administration of higher doses of chemotherapy, radiation therapy, or combined-modality therapy than is otherwise possible, often resulting in increased cure rates (20% to 50%) versus standard-dose therapy. In the past, transplanted marrow cells required 3 weeks to proliferate, leaving the pancytopenic patient prone to bleeding and infections, as well as nonhematologic toxicity caused by the high-dose therapeutic intervention; mortality rates from autologous bone marrow transplantation were 10% to 20%. Now, however, the use of hematopoietic growth factors with primed peripheral blood progenitor cells has resulted in rapid marrow engraftment and a reduction in induction mortality rates to less than 5%. Studies investigating the use of newer hematopoietic growth factors, as well as applying autologous bone marrow transplantation in high-risk remission patients, are currently ongoing.


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