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Conventional and High Dose Chemotherapy for Lymphomas

  • Chapter
Clinical Applications of Cytokines and Growth Factors

Part of the book series: Developments in Oncology ((DION,volume 80))

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Abstract

One of the more promising developments in the treatment of non-Hodgkin’s lymphoma (NHL) is the use of intensive chemotherapy regimens with marrow or blood stem cell support. Such regimens are based on the concept that dose-escalation can overcome intrinsic tumor cell resistance1. Initially, high dose chemotherapy regimens were tested in patients with recurrent and refractory disease. Although impressive response rates were observed in NHL and a fraction of durable remissions, the toxicity of high dose therapy was substantial, preventing its widespread use and generating uncertainty about the value of this treatment in general2. More recently, the use of recombinant cytokines and of peripheral blood stem cells has led to faster and more reliable hematologic recovery, thereby reducing the toxicity associated with high-dose chemotherapy. Treatment-related mortality of less than 5% is now routinely achieved.We will discuss the more recent evolutions in the use of high-dose chemotherapy for the treatment of NHL. We will structure our discussion according to disease histology and take into account the different natural histories of various lymphoid disorders and their outcome with conventional treatment modalities.

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Authors
  1. Koen W. van Besien
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Editors and Affiliations

  1. Bone Marrow Transplant Program, Division of Hematology/Oncology, University of Florida College of Medicine, Shands Hospital, Gainesville, FL, 32610, USA

    John R. Wingard M.D. (Professor of Medicine, Director) (Professor of Medicine, Director)

  2. Department of Adult Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, 02115, USA

    George D. Demetri M.D. (Assistant Professor of Medicine) (Assistant Professor of Medicine)

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van Besien, K.W. (1999). Conventional and High Dose Chemotherapy for Lymphomas. In: Wingard, J.R., Demetri, G.D. (eds) Clinical Applications of Cytokines and Growth Factors. Developments in Oncology, vol 80. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5013-6_16

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