title: [Treatment of resistant or relapsing Hodgkin's disease with high doses of chemotherapy followed by autologous bone marrow transplant].
abstract: Eleven patients with Hodgkin's disease were treated with high-dose chemotherapy followed by autologous bone marrow transplantation (ABMT). Four patients were resistant to initial therapy and 7 patients had relapsed but were progressing under second or third line therapy. The median time from initial diagnosis to transplantation was 44 months (range, 16 to 82). In 9 patients pre-ABMT consisted on high-dose CVB cyclophosphamide, etoposide and carmustine) chemotherapy, one patient was treated with BACT protocol (carmustine, cytosine arabinoside, cyclophosphamide and thioguanine) and other patient was treated with high-dose of busulfan and melphalan. In 8 patients complete remission (CR) was achieved, in one the remission was partial, one failed to respond and one case was not evaluable due to early death. Among CR patients, 2 died from late toxicity, and the other 6 remain in CR off therapy, one of them more than 33 months after ABMT. High-dose therapy produce severe myelosuppression in all patients. There were 3 treatment related death: one early death due to hemorrhagic myocarditis, one veno-occlusive disease of the liver and one due to cytomegalovirus sepsis. The high complete response rate in these heavily pretreated patients suggests that there may be an indication for high-dose therapy and ABMT in earlier resistant Hodgkin's disease. Moreover under such conditions, treatment related morbidity would be expected to be lower.
authors.affiliation: Grup de Transplantament de Medulla Ossia, Hospital de la Santa Creu i Sant Pau, Barcelona.
authors.forename: A
authors.initials: A
authors.lastname: Domingo-Albós
authors.forename: J
authors.initials: J
authors.lastname: García
authors.forename: J
authors.initials: J
authors.lastname: Puig
authors.forename: S
authors.initials: S
authors.lastname: Brunet
authors.forename: R
authors.initials: R
authors.lastname: Ayats
authors.forename: N
authors.initials: N
authors.lastname: Pardo
authors.forename: J
authors.initials: J
authors.lastname: Soler
authors.forename: E
authors.initials: E
authors.lastname: Muñiz
authors.forename: I
authors.initials: I
authors.lastname: Badell
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D004351:Drug Resistance; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D012074:Remission Induction
vernacular_title: Tratamiento de la enfermedad de Hodgkin resistente o en recaída con dosis altas de quimioterapia seguido de trasplante autólogo de medula ósea.