I CORRESPONDENCE AUTOLOGOUS BONE MARROW TRANSPLANTATION IN NONHODGKIN'S LYMPHOMA To the Editor: The report by Hurd et al (Am J Med 1988; 85: 829-834) is undoubtedly an important contribution to the problem of therapy of "poorprognosis" non-Hodgkin's lymphoma (Rosenberg SA: Autologous bone marrow transplantation in non-Hodgkin's lymphoma. N Engl J Med 1987; 316: 1541-1542). Their series of 17 patients received intensive therapy followed by autologous bone marrow transplantation (ABMT) of cryopreserved marrow that was treated in vitro by a combination of three monoclonal antibodies and complement. These monoclonal antibodies (BA-1, BA2, and BA-3) effectively lyse tumor cells ex vivo, and reactivity of the patients' malignant tissue with at least one monoclonal antibody was a prerequisite for inclusion in the study. The authors found that the outcome was largely determined by the status of disease at the time of t r a n s p l a n t a t i o n , whereas prior marrow involvement or the grade of lymphoma did not appear to affect disease-free survival. Surprisingly, however, no mention was made of the reactivity of the patients' neoplastic cells with the monoclonal antibodies as an additional and potent factor. According to the data presented in their Table

I, reactivity with two or three monoclonal antibodies was strikingly related to a favorable response and outcome. Of the eight patients in both the refractory/relapsing and the responding groups whose cells reacted with at least two of the monoclonal antibodies, six remained alive (288 to 1,674 days after transplantation) and only two died (one death due to early sepsis before engraftment, and not due to a relapse). Conversely, of the five patients in both groups whose cells reacted with only a single monoclonal antibody, none remained alive and their median survival was 143 days, as compared to 559 days in the monoclonal'antibodies-reactive group. These groups of patients were small but the differences were highly significant (p