[Autotransplantation in lymphomas: is it effective?].

Recent data suggest that intensive chemotherapy, with or without radiation, followed by a bone marrow autotransplant is effective in advanced intermediate and high-grade non-Hodgkin lymphoma (predominantly large-cell lymphoma). We analyzed 12 studies of the autotransplants to determine outcomes. The results were compared to data from 29 chemotherapy studies. Complete remissions were reported in 53 percent of autotransplant recipients versus 17 percent of persons receiving chemotherapy. Two-year disease-free survival was 16 percent and 3 percent, respectively. It is uncertain whether these differences reflect subject selection or time to treatment (time censoring) biases in the autotransplant cohort. A randomized trial is needed to determine if autotransplants are superior to chemotherapy. Also unknown is whether similar results might not be obtained with higher doses of chemotherapy without an autotransplant.