[High dose chemoradiotherapy and autologous bone marrow transplantation (ABMT) as a first line therapy to treat advanced adult high-grade malignant T-cell non-Hodgkin's lymphoma--a pilot clinical study].

Four patients with advanced adult high-grade malignant T-cell non-Hodgkin's lymphoma (NHL) were treated with high dose chemoradiotherapy and ABMT as a first line therapy. Case 1 was of stage IIIb; case 2, 3 and 4 were of stage IV. Bone marrow was involved (19% blast cells) in case 2, and nervous system was involved in case 4. All of them were given at first an inductive chemotherapy with 3-4 courses of BACOP regimen before ABMT. 40-50 days later, Vp-16, CTX and TBI were given as a conditioning regimen (case 1: TLI). Case 1 and 2 only reached partial remission after inductive treatment (case 2: relapse at primary sites one month after inductive therapy, but complete remission (CR) of bone marrow). All of the four patients reached CR after ABMT. Case 2 had systemic relapse (bone marrow blast cells: 8%) at 110 days after CR and died from relapse 210 days after ABMT. So far, case 1, 3 and 4 have survived free of disease for 24, 19 and 9 months, respectively. There was no fatal marrow transplant regimen-related toxicity during inductive and ABMT treatment. The results of this pilot study suggest that treatment of high-grade malignant NHL may be improved by combined use of high dose chemoradiotherapy and ABMT, and the toxicities can be tolerated.