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document
Comparison of autologous bone marrow transplantation with sequential chemotherapy for intermediate-grade and high-grade non-Hodgkin 's lymphoma in first complete remission : a study of 464 patients . Groupe d'Etude des Lymphomes de l'Adulte . PURPOSE Intensive chemotherapy followed by autotransplantation has given promising results in partially responding or sensitive relapsed patients with aggressive non-Hodgkin 's lymphoma . In 1987 , we designed a randomized study to evaluate the potential benefit of a high-dose regimen containing cyclophosphamide , carmustine , and etoposide ( CBV ) followed by autotransplantation over a consolidative sequential chemotherapy ( ifosfamide , etoposide , asparaginase , and cytarabine ) in patients in first complete remission with intermediate- and high-grade non-Hodgkin 's lymphoma . PATIENTS AND METHODS Patients were younger than 55 years and had at least one adverse prognostic factor . Induction treatment was that of the LNH84 protocol with an open randomization on the anthracycline . Patients in complete remission were further randomly assigned to receive either consolidation procedure . RESULTS After induction treatment , 464 patients were assessable for the consolidation phase . With a median follow-up duration of 28 months , the 3-year disease-free survival rate was 52 % ( 95 % confidence interval , 45 % to 59 % ) in the sequential chemotherapy arm and 59 % ( 95 % confidence interval , 52 % to 66 % ) in the autologous transplant arm ( P = .46 , relative risk = 0.90 ) . The 3-year survival rate did not differ between sequential chemotherapy and autotransplantation , at 71 % ( 95 % confidence interval , 64 % to 78 % ) and 69 % ( 95 % confidence interval , 62 % to 76 % ) , respectively ( P = .60 , relative risk = 1.11 ) . CONCLUSION For such a subset of patients , consolidation with the CBV regimen followed by autologous bone marrow transplantation is not superior to sequential chemotherapy .
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Intervention_Pharmacological
high-dose regimen containing cyclophosphamide
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Intervention_Pharmacological
carmustine
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Intervention_Pharmacological
etoposide ( CBV )
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Intervention_Control
autotransplantation over a consolidative sequential chemotherapy
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Intervention_Pharmacological
ifosfamide
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Intervention_Pharmacological
etoposide
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Intervention_Pharmacological
asparaginase
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Intervention_Pharmacological
cytarabine
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Intervention_Pharmacological
anthracycline .
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Outcome_Physical
complete remission :
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Outcome_Physical
benefit
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Outcome_Physical
complete remission
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Outcome_Mortality
3-year disease-free survival rate
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Outcome_Mortality
3-year survival rate
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Outcome_Other
superior
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Participant_Condition
intermediate-grade and high-grade non-Hodgkin 's lymphoma in first complete remission :
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Participant_Sample-size
464
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Participant_Condition
patients with aggressive non-Hodgkin 's lymphoma
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Participant_Age
younger than 55 years
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Participant_Sample-size
464 patients