[Role of autologous stem cell transplantation in the treatment of Hodgkin's lymphoma].
Among lymphomas, treatment of Hodgkin's disease (HD) allows the highest cure-rate. Radiotherapy (RT) represents first choice therapy in early stages, providing complete remission (CR) rate even superior to 90%. Chemotherapy (CHT) or, when indicated, the combined modality treatment (CHT + RT) is successful, in terms of long overall survival (> 10 yrs) in more than 60% of patients with advanced stage disease at onset. Considering all stages of disease at onset, about 75% of patients can be cured. However, the remaining 25% results resistant to the conventional approach (CHT +/- RT) or, mainly, relapses after first CR. For these poor prognosis patients, it has been assessed the possibility of inducing (or reinducing) a CR by using high dose CHT with stem cells rescue. Autologous stem cell transplantation (ASCT) consists in the administration of antiblastic drugs at so high dosages to require the consequent reinfusion of stem cells, preventively harvested and cryopreserved, thus dramatically decreasing the risk of a prolonged bone marrow aplasia. This procedure is currently performed as intensification treatment in selected cases of patients with advanced stage at onset, once in CR after first-line therapy. Therefore, the development of prognostic models aimed to define with higher sensibility and specificity patients at high risk of relapse and to be submitted to ASCT as consolidation therapy, is becoming of increasing interest.
Barillari
G
G
Istituto di Immunoematologia e Transfusionale, Azienda Ospedaliera S. Maria della Misericordia, Udine.
Fanin
R
R
Biffoni
F
F
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors; D014182:Transplantation, Autologous