Treatment of relapsed and refractory Hodgkin's disease with high dose chemotherapy and autologous bone marrow transplantation.
Despite combination of chemotherapy and radiotherapy, some patients with refractory or relapsed Hodgkin's disease (HD) have a bad prognosis. We performed high dose chemotherapy (HDCT) (BCV regimen) with autologous bone marrow transplantation (ABMT) in 26 patients with advanced HD. 11 patients were considered refractory after at least two non cross-resistant chemotherapy regimens and radiotherapy in 8 cases. 15 patients had a poor prognosis relapse (in visceral or irradiated site) after complete remission and they received chemotherapy before ABMT. At the time of transplantation 4 patients had progressive disease with B symptoms and did not respond to HDCT; they all died 3 to 12 months post-transplantation from persistent HD. For the remaining 22 patients, 3 months after HDCT 19 patients (73%) were in complete remission, 2 (8%) in partial remission and one patient died from toxicity. After complete remission 4 patients relapsed at 12 to 18 months and 15 patients are in persistent remission 24 to 46 months after transplantation. These results are encouraging in patients with bad prognostic factors but able to respond to chemotherapy.
Brice
P
P
Institut d'Hématologie, Hôpital Saint-Louis, Paris, France.
Gisselbrecht
C
C
Ferme
C
C
Lepage
E
E
Baruchel
A
A
Marolleau
J P
JP
Gerota
O
O
Boiron
M
M
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016465:Bone Marrow Purging / Q000379:methods; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002330:Carmustine / Q000008:administration & dosage; D002648:Child; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004351:Drug Resistance; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D015993:Life Tables; D008297:Male; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D016879:Salvage Therapy; D016019:Survival Analysis; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation
D005047:Etoposide; D003520:Cyclophosphamide; D002330:Carmustine