增强剂量CTOP方案治疗NHL临床观察

目的:观察增强剂量CTOP方案治疗NHL(非霍奇金淋巴瘤)的疗效及不良反应,进而探讨提高THP(吡柔比星)在联合化疗方案中的剂量强度的安全性.方法:39例初治NHL随机分为两组分别接受常规剂量CTOP(THP 40mg/m2)和增强剂量CTOP(THP 60mg/m2)方案化疗至少2疗程,观察疗效及不良反应.结果:增强剂量CTOP与常规剂量CTOP方案相比完全缓解率有所提高(47.4%:21.1%),达到完全缓解的时间也缩短(P＜0.01);而且提高THP剂量强度后并未增加心脏毒性、脱发及骨髓抑制等不良反应的发生,两组的不良反应发生率及严重程度相仿,无显著性差异.结论:增强剂量CTOP方案治疗NHL可提高疗效而不加重不良反应,增强剂量吡柔比星可安全使用.     

增强剂量CTOP方案治疗侵袭性淋巴瘤的5年生存分析

目的：分析增强剂量CTOP方案治疗侵袭性非霍奇金淋巴瘤（non-Hodgkin＇s lymphoma，NHL）的疗效及生存期情况，探讨提高吡柔比星（pirarubicine，THP）在联合化疗方案中的剂量强度后患者的生存情况。方法：38例初治侵袭性NHL随机分为2组，分别接受常规剂量CTOP（THP40mg／m^2）和增强剂量CTOP（THP60mg／m^2）方案化疗至少2个疗程，观察疗效及不良反应，收集这部分患者的5年生存数据，进行统计分析。结果：增强剂量CTOP与常规剂量CTOP方案相比，在不增加心脏毒性、脱发及骨髓抑制等不良反应的前提下，近期疗效及生存率有所改善。常规剂量组和增强剂量组1、3、5年生存率分别为94．7％、47．4％、5．3％和84．2％、63．2％、10．5％；1、3、5年无进展生存率分别为84．2％、42．1％、5．3％和78．9％、57．9％、10．5％。2组中位至疾病进展时间分别为11和13个月（P=0．6681）。结论：增强剂量CTOP方案（增强THP剂量）治疗NHL，有可能提高肿瘤完全缓解率（P值未显示统计学差异）及生存率，而且不加重不良反应。     

高剂量吡喃阿霉素的CTOP方案治疗非霍奇金淋巴瘤

目的　观察高剂量吡喃阿霉素组成的CTOP方案治疗非霍奇金淋巴瘤的疗效及不良反应。方法　 60例初治非霍奇金淋巴瘤随机分为两组 ,分别接受常规剂量吡喃阿霉素的CTOP(THP 40mg/m2 )和高剂量吡喃阿霉素的CTOP(THP 60mg/m2 )方案化疗至少 2个疗程 ,观察疗效及不良反应。结果　高剂量吡喃阿霉素的CTOP与常规剂量吡喃阿霉素的CTOP方案相比完全缓解率有所提高(3 6 6%vs 2 0 % ) ,达到完全缓解的时间也缩短 ,但差异均无显著性 (P >0 0 5 )。提高吡喃阿霉素的剂量强度后并未增加心脏毒性、脱发及骨髓抑制等不良反应的发生 ,两组的不良反应的发生率及严重程度相仿 ,差异无显著性。结论　高剂量吡喃阿霉素组成的CTOP方案治疗非霍奇金淋巴瘤可提高疗效而不加重不良反应 ,高剂量吡喃阿霉素可安全使用。     

CTOP与CHOP方案治疗老年非霍奇金淋巴瘤的临床对照研究

目的探讨CTOP方案治疗初治的老年非霍奇金淋巴瘤(NHL)患者的近期疗效、缓解率、不良反应和T淋巴细胞淋巴瘤的有效率。方法2002年1月至2006年1月我院收治老年NHL60例,随机分为A、B两组。A组采用CTOP方案(THP 30 mg/m2,iv,d1;CTX 500 mg/m2,iv,d1;VCR1 mg/m2,iv,d1;Pred 30 mg/body,po,d1~5);B组:CHOP以同等剂量的ADM取代THP,余同A组。Q3W~Q4W×3~4周。结果CTOP方案治疗T细胞淋巴瘤优于CHOP方案,A、B组CR率分别为51.4%和19.4%(P<0.05);非血液系统不良反应为心脏毒性、脱发等,CTOP方案发生率低于CHOP方案(P<0.05),血液系统不良反应两组相似,主要是Ⅲ~Ⅳ度骨髓抑制。本组无化疗相关死亡病例。两组方案治疗老年NHL近期疗效相近,但A组生活质量优于B组。结论CTOP方案适合老年NHL的治疗,尤其对T细胞淋巴瘤有治疗优势,毒性反应明显降低,尤其是心脏毒性反应,患者生活质量提高,治疗有效率提高,值得在临床上进一步研究。     

CTOP方案治疗非霍奇金淋巴瘤65例

目的 分析以吡柔比星（THP）为主的联合化疗方案治疗非霍奇金淋巴瘤（NHL）的疗效及患者不良反应.方法 回顾性分析2002年1月至2009年12月收治的118例NHL住院患者的临床病理资料,根据国际抗癌联盟（UICC）实体瘤疗效评价标准、Kamofsky生活质量评分标准和WHO抗癌药物毒性反应评价标准,分析比较近期采用CTOP方案[THP 40 mg/m2,静脉滴注,第1天;环磷酰胺（CTX）750 mg/m2,静脉滴注,第1天;长春新碱（VCR）1.4 mg/m2,静脉滴注,第1天;泼尼松（Pred）1 mg·kg-1·d-1,口服,第1天至第5天]和以往采用CHOP方案[多柔比星（ADM）40 mg/m2,静脉滴注,第1天;CTX 750mg/m2,静脉滴注,第1天;VCR 1.4mg/m2,静脉滴注,第1天;Pred 1mg·kg-1·d-1,口服,第1天至第5天]治疗NHL的疗效及患者不良反应.结果 CTOP方案组（65例）和CHOP方案组（53例）完全缓解（CR）率分别为55.4%、52.8%,总有效率（CR＋PR）分别为83.1%、81.1%,两组比较差异无统计学意义（P＞0.05）;两组间血液系统不良反应、消化道反应、肝肾功能异常的发生率差异无统计学意义（P＞0.05）;心电图异常发生率CTOP方案组为6.2%,CHOP方案组为20.7%,两组间差异有统计学意义（P＜0.05）;脱发发生率CTOP方案组为13.8%,CHOP方案组为100%,两组间差异有统计学意义（P＜0.01）;患者生存质量改善率CTOP方案组为58.5%,CHOP方案组为38.3%,两组间差异有统计学意义（P＜0.05）.结论 CTOP方案与CHOP方案治疗NHL疗效相近,但CTOP方案组心脏毒性和脱发发生率明显低,患者生存质量明显提高.     

紫杉醇联合蒽环类药物治疗晚期乳腺癌的临床观察

目的观察紫杉醇联合吡柔比星(THP)/表阿霉素(E-ADM)治疗晚期乳腺癌患者的临床疗效和不良反应.方法95例患者均为晚期乳腺癌,化疗方案为THP 50 mg/m2或E-ADM70 mg/m2,快速静滴15 min,d1;国产紫杉醇135～175 mg/m2,静滴3 h,d2.21 d为一个周期,连用2个周期以上评价疗效.结果全组95例均可评价疗效,总有效率为40.0%.完全缓解率为15.8%,部分缓解率为24.2%.无治疗相关死亡,主要不良反应为骨髓抑制和脱发.THP组脱发发生率较EADM组少,差异有显著性.结论紫杉醇联合THP/E-ADM化疗晚期乳腺癌缓解率较高,不良反应可耐受,是治疗晚期乳腺癌安全有效的化疗方案.     

以吡柔比星为主联合化疗方案治疗非霍奇金淋巴瘤的临床观察

目的分析以吡柔比星（THP）为主联合化疗治疗非霍奇金淋巴瘤（NHL）的疗效和不良反应,并与以比柔比星（ADM）为主的联合化疗方案进行比较。方法128例NHL患者中65例用THP为主的化疗方案（CTOP方案）（THP组）,63例用以ADM为主的化疗方案（CHOP方案）（ADM组）,观察两种方案的近期疗效及不良反应。结果THP组和ADM组的治疗有效率分别为87．7％和81．0％,两组间比较差异无统计学意义（P〉O．05）。骨髓抑制、恶心、呕吐、肝功能异常发生率两组间比较差异无统计学意义（P值均〉0．05）,THP组的脱发率、心电图（ECG）异常发生率均显著低于ADM组（P〈0．05）。结论THP、ADM治疗NHL疗效相似,但THP导致的脱发、心脏毒性低于ADM。     

CTOP方案治疗非霍奇金淋巴瘤65例疗效分析

 目的　观察分析以吡柔比星 （THP）为主的联合化疗方案治疗非霍奇金淋巴瘤（NHL）的疗效及患者不良反应。方法　回顾性分析2002年1月至2009年12月收治的118例NHL住院患者临床病理资料,根据UICC实体瘤疗效评价标准、Karnofsky生活质量评分标准和WHO抗癌药物毒性反应评价标准,分析比较近期采用CTOP方案[THP 40 mg／m2,静脉注射,第1天;环磷酰胺（CTX）750 mg／m2,静脉注射,第1天;长春新碱（VCR）1.4 mg／m2,静脉注射,第1天;泼尼松（Pred）1 mg·kg-1·d-1,口服,第1天至第5天]和以往采用CHOP方案[多柔比星（ADM）40 mg／m2,静脉注射,第1天;CTX 750 mg／m2,静脉注射,第1天;VCR 1.4 mg／m2,静脉注射,第1天;Pred 1 mg·kg-1·d-1,口服,第1天至第5天]治疗的NHL的疗效及不良反应。结果　CTOP方案组（65例）和CHOP方案组（53例）完全缓解（CR）率分别为55.4 %、52.8 %,总有效率（CR+PR）分别为83.1 %、81.1 %,2组比较差异无统计学意义（P＞0.05）;2组间血液系统毒副作用（白细胞减少、血小板减少）,消化道反应（恶心、呕吐）,肝肾功能异常的发生率差异无统计学意义（P＞0.05）;心电图异常发生率CTOP方案治疗组为6.2 %,CHOP方案组为20.7 %,2组间差异有统计学意义（P＜0.05）;脱发发生率CTOP方案治疗组为13.8 %,CHOP方案组为100 %,2组间差异有统计学意义（P＜0.01）;患者生存质量改善率,CTOP方案治疗组为58.5 %,CHOP方案组为38.3 %,2组间差异有统计学意义（P＜0.05）。结论　用CTOP方案治疗NHL与CHOP方案比较,在疗效上差异无统计学意义（P＞0.05）,但心脏毒副作用和脱发发生率明显低于CHOP方案,且患者生存质量也比CHOP方案明显提高。     

THP-COP方案治疗老年人非霍奇金淋巴瘤34例

目的 观察以吡柔比星(THP)为主的THP-COP方案治疗老年人非霍奇金淋巴瘤(NHL)的临床疗效及毒副作用.方法 34例老年人NHL患者采用THP、环磷酰胺(CTX)、长春新碱(VCR)、泼尼松(PDN)联合化疗,配合输血及粒细胞集落刺激因子(G-CSF)应用.结果 完全缓解35-3%,部分缓解47%,稳定8.8%,进展8.8%,心脏毒性轻微.结论以THP为主的THP-COP方案治疗老年人NHL安全有效.     

含吡柔比星方案治疗骨肉瘤肺转移患者的疗效及心脏功能评估

目的:本研究旨在探讨含吡柔比星(pirarubicin, THP)方案治疗骨肉瘤肺转移患者的疗效,并对心脏功能等相关不良反应进行评估.方法:32例骨肉瘤肺转移患者接受THP (50 mg/m2, d 1)联合顺铂(cisplatin, DDP)(80 mg/m2,分成2～3 d)或异环磷酰胺(ifosfamide, IFO)(8 g/m2,分成4 d)治疗,评价近期疗效.应用心脏超声检测患者THP治疗前后左室射血分数和E/A值等心脏功能指标.结果: 含THP方案治疗骨肉瘤肺转移患者中位总生存时间为(31.00±7.98)个月,无疾病进展时间为(13.00±2.46)个月,客观缓解率为46.88%,部分缓解率为40.63%.含THP方案化疗的不良反应主要为胃肠反应和骨髓抑制;THP不同累积剂量组左室射血分数差异无统计学意义,THP累积剂量较大组的E/A值较化疗前明显降低(P＜0.05).结论:含THP方案治疗骨肉瘤肺转移患者是较为有效和安全的,可以作为挽救性化疗选择方案.二维彩色多普勒超声技术可作为评价蒽环类药物早期心脏毒性的检测手段之一.     

Phase II trial of irinotecan (CPT-11) in relapsed or refractory non-Hodgkin's lymphomas

CPT11, a camptothecin analogue, is a specific DNA topoisomerase I inhibitor, with activity in tumor cell lines with MDR expression. CPT11 has a broad spectrum of activity in solid tumors (especially in colorectal, gastric and small cell lung cancers). Early reports have shown that CPT11 could be active in non-Hodgkin's lymphomas (NHL) with low-dose schedules. To further evaluate the efficacy and toxicity of CPT11 in patients with refractory or relapsed NHLs, we conducted a phase II trial with escalated doses. PATIENTS AND THERAPY: From 04/98 to 05/01, 28 patients with NHL were enrolled. PATIENTS CHARACTERISTICS: M/F 21/7; median age: 56 years (range 28-72); Ann Arbor stage at the time of the study I/II and III/IV in 6 and 21 patients, respectively. Sixteen patients had refractory disease when they were enrolled in this phase II study and 8 patients were previously treated with high-dose therapy and stem-cell transplantation. CPT11 was administrated at the doses of 350 mg/m2 every 3 weeks. Six courses were given in patients who achieved CR, PR or stable disease. Patients were evaluated every 2 courses. If no grade II or more toxicity was observed after the first course, escalated dose (500 mg/m2) was then undertaken. RESULTS: 19/28 patients received more than 2 courses of CPT11 and were evaluated for response. Nine patients received one course of therapy because of either progressive disease (n = 6), toxicity (n = 2) or refusal (n = 1). Ten patients received escalated dose (500 mg/m2). Complete remission and partial was achieved in 2/19 patients, stable disease in 7/19, and progressive disease in 10/19 patients. Median duration of responses was short (3 months, range 1-8 months). Seventy-five courses were evaluated for toxicity according to the WHO criteria. Diarrhea grade 2 or 3 occurred in 9/75 courses; cholinergic syndrome grade 2 in 3/75 courses; nausea grade 3 in 7/75 courses. Hematological toxicity: leucopenia grade 3 or 4 in 21/75 courses; thrombocytopenia grade 3 in 8/75 courses; infectious episodes grade 2 or 3 in 7/75 courses. In 2/7 courses with escalated doses, grade I/IV neutropenia occurred withoutother major toxicity. CONCLUSION: CPT11 has low activity in heavily pretreated NHLs. Responses were of short duration.     

Phase II study of tetrahydropyranyl adriamycin (pirarubicin) in elderly patients with advanced breast cancer.

Thirty elderly (over 70 years) women with measurable advanced breast cancer entered into this Phase II study. An initial dose of 30 mg/m2 of pirarubicin (THP) every 3 weeks was given intravenously. THP was escalated by levels of 10 mg/m2 according to the blood cell count done at day 14 and day 21 until a maximum dose per cycle of 70 mg/m2 was reached. The mean total cumulative dose of THP received was 204 mg/m2 (range 30-710 mg/m2). The mean number of cycles given was 5.5 (range 1-24). Of 28 evaluable patients, 1 achieved a complete response (CR), 6 had a partial response (PR) (CR + PR = 25%; 95% confidence interval 9-41%), 13 showed no change, and 5 had a progressive disease. The median time to progression was 3 months (range 0.5-18+ months). Of 28 patients evaluable for toxicity, the hematologic toxicity at day 15 was neutropenia grade 3 and 4 in 61% of the patients and thrombopenia grade 3 and 4, 0% of cycles. No cumulative hematologic toxicity was detected. Nonhematologic toxicities consisted of nausea and vomiting in 50% of patients (WHO grade 3 = 5%) and alopecia in 64% (WHO grade 2-3 = 36%). No stomatitis occurred. No cardiac toxicity was observed. The results of this study show that THP is an active drug in elderly patients with advanced breast cancer. Because of its safety, THP deserves further investigation in this application.     

Autologous transplantation for diffuse aggressive non-Hodgkin's lymphoma in patients never achieving remission: a report from the Autologous Blood and Marrow Transplant Registry.

PURPOSE: To evaluate the results of high-dose chemotherapy and autologous hematopoietic stem-cell transplantation (autotransplants) in patients with diffuse aggressive non-Hodgkin's lymphoma (NHL) who never achieve a complete remission with conventional chemotherapy. PATIENTS AND METHODS: Detailed records from the Autologous Blood and Marrow Transplant Registry (ABMTR) on 184 patients with diffuse aggressive NHL who never achieved a complete remission with conventional chemotherapy and subsequently received an autotransplant were evaluated. Transplants were performed between 1989 and 1995 and were reported to the ABMTR by 48 centers in North and South America. RESULTS: Seventy-nine (44%) of 184 patients achieved a complete remission or a complete remission with residual imaging abnormalities of unknown significance after autotransplantation. Thirty-four (19%) of 184 had a partial remission and 55 (31%) of 184 had no response or progressive disease. Eleven patients (6%) were not assessable for response because of early death. The probabilities of progression-free and overall survival at 5 years after transplantation were 31% (95% confidence interval [CI], 24% to 38%) and 37% (95% CI, 30% to 45%), respectively. In multivariate analysis, chemotherapy resistance, Karnofsky performance status score less than 80 at transplantation, age > or = 55 years at transplantation, receiving three or more prior chemotherapy regimens, and not receiving pre- or posttransplant involved-field irradiation therapy were adverse prognostic factors for overall survival. CONCLUSION: High-dose chemotherapy and autologous hematopoietic stem-cell transplantation should be considered for patients with diffuse aggressive NHL who never achieve a complete remission but who are still chemotherapy-sensitive and are otherwise transplant candidates.     

Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood

BACKGROUND: The purpose of the current study was to evaluate the activity and toxicity of dexamethasone, high-dose cytarabine, and carboplatin (DAC) combination therapy in children with newly diagnosed large-cell non-Hodgkin lymphoma (NHL) and to estimate the event-free and overall survival rates achieved when DAC is incorporated into a conventional regimen. METHODS: From 1991 to 1997, 20 boys and 5 girls aged 4.2 to 17.7 years who had stage III (according to the St. Jude staging system) (n = 21) or stage IV (n = 4) large-cell NHL were treated in this study. DAC therapy was administered at the beginning of the induction phase in 2 sequential cycles and incorporated throughout a continuation phase (modified from the ACOP+ regimen, which features doxorubicin, cyclophosphamide, vincristine, and prednisone) with doxorubicin, cyclophosphamide, vincristine, and dexamethasone. The total duration of treatment was approximately 10 months. RESULTS: DAC therapy yielded a response in 22 of 25 patients (88%; 95% confidence interval [95% CI], 68%-97%): complete remission in 13 cases (52%), and partial response in 9 (36%). After additional treatment with doxorubicin, cyclophosphamide, vincristine, and dexamethasone, complete remission was attained in 18 patients (72%) and partial remission in 3 (12%). The event-free survival rate (+/- the standard error [SE]) was 64% +/- 9% and the overall survival rate was 80% +/- 8% at 5 years. CONCLUSIONS: The results of the current study indicate that the DAC regimen is well tolerated and effective for pediatric patients with large-cell NHL.     

Breast cancer after curative chemotherapy in non-Hodgkin's lymphoma: examination of the role of drug resistance and retrospective comparison to the outcome of de novo breast cancer

We examined the outcome of patients who developed breast cancer after curative chemotherapy (CHOP) for aggressive non-Hodgkin's lymphoma (NHL) in comparison to the outcome of a retrospectively selected matched-pair group of patients with de novo breast cancer, and evaluated the role of drug resistance-related protein (MDR, MRP, LRP) expression in breast cancer tissue. Twenty-two patients presented with breast cancer (BC) in complete remission after CHOP for NHL. The median age was 62 (49-70) years, each had high/intermediate grade B-cell NHL treated with 6 courses of CHOP, and were in complete remission. These patients were compared to a matched-pair group of de novo BC patients selected from our database over the same time period. Breast cancer tissue was stained by immunohistochemistry for drug resistance proteins LRP, MRP, and MDR. Breast cancer developed after a median of 26 (9-49) months of NHL diagnosis; breast tumor grades 1-2 were seen in 12, and grade 3 in 10 patients; 15 were negative and 7 weakly positive for estrogen and progesterone receptors. Twelve patients were stage IIIA/B, and 10 stage IV and were treated with conventional chemotherapy regimens. All progressed early in liver (n=13), brain (n=9), lung (n=6), bone (n=8), lymph nodes (n=7) and soft tissue (n=5), and received second-line chemotherapy with mitomycin-C + vinblastine or taxanes. The overall survival was 11.8 (6-26) months (p<0.01). Time from NHL to breast cancer development was 19 (14-27) months in patients with positive drug resistance proteins (group A), and 37 (26-56) months in patients with 1 or 2 positive resistance proteins (group B) (p<0.001). In patients with stage IIIA/B disease, there was no difference between the examined and control matched-pair group in median TTP, but there was in overall survival (OS) (23 vs 36 months, p=0.029). In advanced disease, there were more responders in the control vs the examined group (p=0.07). Patients in the control matched-pair group had more prolonged OS when compared to group A patients who developed BC in <24 months from NHL to BC (p=0.017). We conclude that breast cancer developing shortly after a complete response in NHL, is an aggressive disease variant with minimal potential for response to conventional chemotherapy. Analysis of drug resistance mechanisms concerning MDR, MRP and LRP indicates that most of these patients have BC that overexpress these proteins leading to the suggestion that these mechanisms might be a part of the aggressive disease phenotype and partially explain the poor outcome.     

Early locoregional high-dose radiotherapy is associated with long-term disease control in localized primary angiocentric lymphoma of the nose and nasopharynx.

Nasal NK/T cell is a rare form of usually localized non-Hodgkin's lymphoma (NHL) which generally carries a poor prognosis when treated with conventional NHL chemotherapy protocols. We reviewed 20 consecutive localized stage I/II nasal NK/T cell lymphomas treated at our institution over a 29 year period. Median age was 44 (range 23-71). Front-line therapy was generally radiotherapy alone (35-70 Gy) before 1980 and combination chemotherapy after 1980. Six patients were treated with first-line radiotherapy and they achieved complete remission (CR). Two subsequently received combination chemotherapy. Five of those patients remained in complete remission, after 97+ to 277+ months. Twelve patients were treated with first-line chemotherapy including CHOP or CHOP-like regimen in seven cases, and COP in five cases. Only three of them achieved CR, five had partial response and four had progressive disease. Five of the seven patients treated with CHOP did not achieve complete remission. The nine patients who failed to achieve CR with chemotherapy subsequently received salvage radiotherapy but only two of them obtained CR. Finally, two patients were treated with alternated chemotherapy and radiotherapy and achieved CR, which persisted after 14+ and 26+ months. Median survival was not reached in patients who received front-line radiotherapy, and was 35 months in patients who received front-line chemotherapy. These findings confirm that chemotherapy gives a low complete remission rate in localized nasal NK/T cell lymphoma. By contrast, first-line radiotherapy seems to give favorable results, whereas its results are poorer when administered after resistance to chemotherapy. Whether the use of chemotherapy after radiotherapy, or alternated chemotherapy-radiotherapy regimens give better clinical results than radiotherapy alone will have to be evaluated prospectively in this type of NHL.     

Dose-escalated total body irradiation and autologous stem cell transplantation for refractory hematologic malignancy

PURPOSE: To evaluate the feasibility of dose escalation of total body irradiation (TBI) above the previously reported maximally tolerated dose, we have undertaken a Phase I-II trial of dose-escalated TBI with autologous peripheral blood stem cell transplantation (PBSCT) for chemotherapy-refractory lymphoma. METHODS AND MATERIALS: Nine lymphoma patients with primary refractory disease (PRD) or in resistant relapse (RR) received dose-escalated TBI and PBSCT. The three dose levels of fractionated TBI (200 cGy twice daily) were 1,600 cGy, 1,800 cGy, and 2,000 cGy. Lung blocks were used to reduce the TBI transmission dose by 50%, and the chest wall dose was supplemented to the prescribed dose using electrons. Shielding of the kidneys was performed to keep the maximal renal dose at 1,600 cGy. Three patients, two with non-Hodgkin's lymphoma (NHL) in RR and one with PRD Hodgkin's disease, received 1,600 cGy + PBSCT, three patients (two NHL in RR, one PRD) received 1,800 cGy + PBSCT, and three patients with NHL (two in RR, one PRD) received 2,000 cGy + PBSCT. RESULTS: Toxicities associated with this high-dose TBI regimen included reversible hepatic veno-occlusive disease in 1 patient, Grade 2 mucositis requiring narcotic analgesics in 8 patients, and neurologic toxicities consisting of a symmetrical sensory neuropathy (n = 4) and Lhermitte's syndrome (n = 1). Interstitial pneumonitis developed in 1 patient who received 1,800 cGy after receiving recombinant alpha-interferon (with exacerbation after rechallenge with interferon). Six (66%) patients achieved a response. Four (44%) patients achieved complete responses, three of which were of a duration greater than 1 year, and 2 (22%) patients achieved a partial response. One patient remains disease-free more than 5 years posttransplant. Corticosteroid-induced gastritis and postoperative infection resulted in the death of 1 patient in complete response, 429 days posttransplant. CONCLUSION: TBI in a dose range 1,600-2,000 cGy as preparative therapy for autologous PBSCT is feasible and has substantial activity in chemorefractory non-Hodgkin's and Hodgkin's lymphoma.