Autologous peripheral blood stem cell transplantation as compared with salvage chemotherapy in children with relapsed lymphomas

A total of 39 patients with relapses of lymphoma were treated between July 1998 and October 2004. All patients received prior conventional 1st line chemotherapy followed by salvage or second line chemotherapy. The patients who had a response to salvage or second line chemotherapy (27 patients) were randomly assigned to continue either salvage or second line chemotherapy alone (14 patients) or salvage chemotherapy plus intensive chemotherapy and autologous stem cell transplantation (13 patients). The overall rate of response to salvage or 2nd line conventional chemotherapy was 69.2% for relapsed lymphoma children. The response rate was 61.1% for non-Hodgkin lymphoma patients and 76.2% among those with Hodgkin's disease. There were 5 deaths among the patients in the transplantation group, and 8 among those in the group receiving chemotherapy without transplantation. The two groups did differ in terms of prognostic factors. The median follow-up time was 24 months. The response rate was 61.5% after autologous stem cell transplantation and 42.9% after chemotherapy without transplantation. At 2 years, the rate of event-free survival was 15.3% in the transplantation group and 8.3% in the group receiving chemotherapy without transplantation (P=0.18), and the rate of overall survival was 26.7% and 46.3% respectively (P=0.005). As compared with salvage chemotherapy, treatment with high-dose chemotherapy and autologous peripheral blood stem cell transplantation insignificantly increases event-free survival in children with relapsed lymphomas. Copyright © Hellenic Society of Haematology.