{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:50:17Z","timestamp":1761490217181},"reference-count":65,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2000,2,1]]},"abstract":"<jats:p>PURPOSE: To evaluate the long-term results of high-dose therapy (HDT) in follicular lymphoma, with specific emphasis on the prognostic significance of polymerase chain reaction (PCR)\u2013detectable Bcl-2\/IgH rearrangements.<\/jats:p><jats:p>PATIENTS AND METHODS: Between June 1985 and October 1995, 99 patients with follicular lymphoma received HDT as consolidation of second or subsequent remission. Bone marrow was treated in vitro with anti\u2013B-cell antibodies and complement.<\/jats:p><jats:p>RESULTS: Sixty-five patients remained alive, 49 treatment-failure free, with a median follow-up of 5.5 years (range, 1.5 to 12.5 years). Four \u201cearly\u201d and 10 \u201clate\u201d deaths occurred from treatment-related causes; seven of the latter were due to secondary myelodysplasia (s-MDS) or secondary acute myeloblastic leukemia. Overall, 12 (12%) of the 99 patients developed s-MDS or acute myeloblastic leukemia. Kaplan-Meier estimates of freedom from recurrence (FFR) and survival rates at 5 years were 63% (95% confidence interval [CI], 52% to 72%) and 69% (95% CI, 58% to 78%), respectively. For all 99 patients, in multivariate analysis, absence of the Bcl-2\/IgH rearrangement at the time of diagnosis (hazards ratio [HR], 0.39; P = .04) and three or fewer treatment episodes before HDT (HR, 0.03; P = .001) were significant prognostic factors for improved survival. For patients bearing Bcl-2\/IgH rearrangements, in univariate and multivariate analyses, absence of a PCR-detectable Bcl-2\/IgH rearrangement during follow-up was associated with a significantly lower risk of recurrence (adjusted HR, 0.13; P &lt; .001) and death (HR, 0.25; P = .02), whereas the PCR status of the reinfused bone marrow did not correlate with outcome.<\/jats:p><jats:p>CONCLUSION: Prolonged FFR can be achieved in patients with follicular lymphoma after HDT, but as yet there is no survival advantage compared with conventional treatment. These results confirm that elimination of cells bearing the Bcl-2\/IgH rearrangement is highly desirable and should be attempted. The incidence of s-MDS is of increasing concern in this setting.<\/jats:p>","DOI":"10.1200\/jco.2000.18.3.527","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T07:04:24Z","timestamp":1487919864000},"page":"527-527","source":"Crossref","is-referenced-by-count":143,"title":["High-Dose Therapy With Autologous Bone Marrow Support as Consolidation of Remission in Follicular Lymphoma: Long-Term Clinical and Molecular Follow-Up"],"prefix":"10.1200","volume":"18","author":[{"given":"John","family":"Apostolidis","sequence":"first","affiliation":[{"name":"From the Imperial Cancer Research Fund Medical Oncology UnitDepartment of Medical Oncology, and Departments of Histopathology and Hematology, St Bartholomew\u2019s Hospital, London; and Imperial Cancer Research Fund Centre for Statistics in Medicine, Institute of Health Sciences, Oxford, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajnish K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"From the Imperial Cancer Research Fund Medical Oncology UnitDepartment of Medical Oncology, and Departments of Histopathology and Hematology, St Bartholomew\u2019s Hospital, London; and Imperial Cancer Research Fund Centre for Statistics in Medicine, Institute of Health Sciences, Oxford, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demetrios","family":"Grenzelias","sequence":"additional","affiliation":[{"name":"From the Imperial Cancer Research Fund Medical Oncology UnitDepartment of Medical Oncology, and Departments of Histopathology and Hematology, St Bartholomew\u2019s Hospital, London; and Imperial Cancer Research Fund Centre for Statistics in Medicine, Institute of Health Sciences, Oxford, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter W. 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