What is the value of autologous bone marrow transplantation in the treatment of relapsed or resistant Hodgkin's disease?
The treatment of Hodgkin's disease after relapse from chemotherapy or when resistant to chemotherapy rarely results in cure. For this reason high dose therapy and autologous bone marrow transplantation (ABMT) have been explored in an attempt to overcome drug resistance by drug escalation. The results of studies published to date are encouraging but the procedure is not without significant morbidity and mortality. The answer as to whether high dose therapy and ABMT represent an improvement over conventional salvage therapy will have to await the results of randomized trials. It remains possible that the encouraging results achieved so far have been achieved by inadvertent patient selection.
McMillan
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Department of Haematology, University College Hospital, School of Medicine, London, U.K.
Goldstone
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D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002330:Carmustine / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004351:Drug Resistance; D005047:Etoposide / Q000008:administration & dosage; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000473:pathology; D006689:Hodgkin Disease / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage; D009503:Neutropenia / Q000209:etiology; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D013997:Time Factors; D014182:Transplantation, Autologous
D016298:Hematopoietic Cell Growth Factors; D003561:Cytarabine; D005047:Etoposide; D003520:Cyclophosphamide; D008558:Melphalan; D002330:Carmustine