Bone marrow transplants from HLA-identical siblings in advanced Hodgkin's disease.
OBJECTIVE
To determine the outcome of HLA-identical sibling bone marrow transplants in advanced Hodgkin's disease.


METHODS
We reviewed the data on 100 consecutive patients with Hodgkin's disease who received HLA-identical sibling bone marrow transplants between April 1, 1982 and August 12, 1992, reported to the International Bone Marrow Transplant Registry (IBMTR). The median interval from diagnosis to transplant was 2.5 years (range, < 1 to 14). All had advanced disease. Eighty-nine of 100 patients were not in remission at the time of transplant. Fifty had pretransplant Karnofsky scores less than 90% and 27 had active infection in the week before transplant. Patients received a variety of conditioning regimens; 45 received total-body radiation.


RESULTS
The 100-day probability of acute graft-versus-host disease (GVHD) was 35% (95% confidence interval [CI], 26% to 46%); the 3-year probability of chronic GVHD was 45% (95% CI, 31% to 59%). The 3-year probability of relapse was 65% (95% CI, 50% to 78%). The 3-year probability of survival was 21% (95% CI, 14% to 30%). The 3-year disease-free survival rate was 15% (95% CI, 9% to 24%).


CONCLUSIONS
HLA-identical sibling bone marrow transplants have a limited role in advanced Hodgkin's disease.
Gajewski
J L
JL
International Bone Marrow Transplant Registry, Health Policy Institute, Medical College of Wisconsin, Milwaukee 53226, USA.
Phillips
G L
GL
Sobocinski
K A
KA
Armitage
J O
JO
Gale
R P
RP
Champlin
R E
RE
Herzig
R H
RH
Hurd
D D
DD
Jagannath
S
S
Klein
J P
JP
Lazarus
H M
HM
McCarthy
P L
PL
Pavlovsky
S
S
Peterson
F B
FB
Rowlings
P A
PA
Russell
J A
JA
Silver
S M
SM
Vose
J M
JM
Wiernik
P H
PH
Bortin
M M
MM
Horowitz
M M
MM
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006680:HLA Antigens / Q000032:analysis*; D006648:Histocompatibility; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D006680:HLA Antigens