Conventional and High Dose Chemotherapy for Lymphomas

  • Koen W. van Besien
Part of the Developments in Oncology book series (DION, volume 80)


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.


Clin Oncol Follicular Lymphoma Mantle Celllymphoma International Prognostic Index Bone Marrow Involvement 
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  • Koen W. van Besien

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