[Outcome of 70 patients diagnosed with Hodgkin's disease after first-line and salvage treatment: experience at one center].
BACKGROUND
Retrospective analysis of 70 patients with Hodgkin's disease (HD) and treated consecutively in our center between 1979 and 1993.


METHODS
All ganglionar biopsies were reviewed and finally 60 patients were selected: 43 males and 17 females with a median age of 39 years (12-79) and the following features: 55% III-IV stages, 25% extranodal involvement, 32% bulky mediastinum and 57% B-symptoms. Scheme of treatment: Only radiotherapy in 9 patients with localized stages and no adverse factors; only chemotherapy in 25 with advanced stages and combined therapy in 15 with localized stages and any adverse factor and in 7 with advanced stage and bulky disease. Chemotherapy was mainly based on MOPP until 1987 and MOPP/ABVD afterwards. Only four patients did not follow this scheme: 2 due to progression, 1 due to toxicity and 1 due to medical decision.


RESULTS
Fifty patients achieved complete remission (CR), 2 partial and 8 minimal response or progression under therapy. Eleven patients have died: 6 due to HD, 4 of second neoplasias and 1 of an opportunistic infection. With a median follow-up for surviving patients of 4.8 years (1-2), the estimated overall survival at 8 years is 67.7% (SD 9%), tumor mortality 82.6% (SD 7%) and progression free survival 66.7% (SD 7%). Disease free survival for CR patients is 78.4% (SD 9%). Response to treatment was the only factor significantly associated with survival (p = 0.0001). The estimated survival for CR patients who relapsed is 92.3% versus 28% for those who did not obtain a CR (p = 0.0001).


CONCLUSIONS
In our experience, first line therapy adjusted to clinical features at diagnosis has good results. Response to treatment has been the determinant factor for survival, mostly because salvage treatments, including high-dose chemotherapy approaches, have been of little effectiveness.
Arranz
R
R
Servicio de Hematología, Hospital Universitario de la Princesa, Madrid.
Gil-Fernández
J J
JJ
Muñoz
E
E
Acevedo
A
A
Sobrino
M P
MP
Fernández-Rañada
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D015993:Life Tables; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011344:Procarbazine / Q000008:administration & dosage / Q000009:adverse effects; D011867:Radioisotope Teletherapy / Q000009:adverse effects; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D001761:Bleomycin; D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin; D011241:Prednisone