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OS, overall survival; CCR, continuous complete remission; DFS, disease-free survival; CLL/SL, chronic lymphocytic leukemia/small lympho-cytic lymphoma; EFS, event-free survival; PFS, progression-free survival.

OS, overall survival; CCR, continuous complete remission; DFS, disease-free survival; CLL/SL, chronic lymphocytic leukemia/small lympho-cytic lymphoma; EFS, event-free survival; PFS, progression-free survival.

with transformed lymphomas (P = 0.04). A small series from the European Bone Marrow Transplant Group also noted that results of autologous stem cell transplantation were poor for patients with transformed lymphomas.78 A retrospective analysis from Dana-Farber Cancer Institute compared outcomes of autolo-gous stem cell transplantation in 51 patients with low-grade lymphomas and 18 patients following transformation to lymphomas with diffuse architecture.79 The 4-year disease-free survival was 23% for patients with transformed lymphomas, as compared with 47% for patients with low-grade histology, although this difference was not statistically significant (P = 0.2).

Other analyses have demonstrated somewhat better results of transplantation for patients with transformed lymphomas. A series from Boston found no differences in time to treatment failure when autolo-gous transplants in 10 patients with transformed lymphomas were compared to 68 patients with intermediate- and high-grade histology who were treated with autologous transplantation.80 A series from Sweden compared results of autologous bone marrow and stem cell transplantation of 11 patients with follicular lymphoma and 11 with transformed lymphomas.81 No significant differences in disease-free survival were noted. The Stanford group reported that the actuarial 4-year disease-free survival and 4-year overall survival were 49 and 50%, respectively, in 17 patients with transformed lymphomas who had undergone autologous bone marrow or stem cell transplantation.82 These results were similar to patients with follicular low-grade lymphomas and follicular large-cell lymphomas who had been transplanted. The group from Cleveland Clinic also examined results of autologous peripheral blood stem cell transplantation for patients with lymphomas that had transformed to diffuse large-cell histology.83 The actuarial 4-year overall survival and event-free survival rates were 61 and 38%, respectively (Table 67.3). These values were 53 and 37%, respectively, in a group of transplanted patients with de novo diffuse large-cell histology (P = ns). An analysis from the European Bone Marrow Transplant Registry showed that actuarial 5-year overall survival and progression-free survival rates were 51 and 30%, respectively, in 50 patients who received autologous hematopoietic stem cell transplants for follicular lymphomas (Table 67.3; Figure 67.3).87 No significant differences in overall survival or progression-free survival were identified when these values were compared to transplanted patients with low-grade (P = 0.939 and 0.673, respectively) or intermediate/high-grade histology (P = 0.438 and .533, respectively).

Investigators from Seattle have piloted a novel regimen combining 131I tositumomab (see above) with high-dose etoposide and cyclophosphamide, followed

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