title: Conventional salvage chemotherapy vs. high-dose therapy with autografting for recurrent or refractory Hodgkin's disease patients.
abstract: Despite progress that has been made in curing Hodgkin's disease (HD), patients whose first remission is brief and those resistant to first-line chemotherapy still have a poor outcome. We retrospectively reviewed data from 29 patients with HD in first relapse or refractory to first-line chemotherapy. Following failure, all patients received three cycles of ifosfomide, epirubicin, and etoposide (IEV); moreover, 11 patients received a conditioning regimen followed by autografting. Of the 18 patients treated with IEV, eight (44%) are alive; nine died of disease progression, and one died of hematologic toxicity. The 24-month overall survival (OS), relapse-free survival (RFS), and event-free survival (EFS) are 18%, 44%, and 22%, respectively. Of the 11 patients treated with IEV and autografting, ten are alive (90%) and one patient died of progressive disease. The 29-month OS, RFS, and EFS are 91%, 71%, and 56%, respectively. Our results confirm data showing that patients with relapsed or resistant HD achieve a significantly better OS and EFS if treated with high-dose therapy and autografting.
authors.affiliation: Dipartimento Biotecnologie Celluari ed Ematologia, Università La Sapienza, Rome, Italy.
authors.forename: A P
authors.initials: AP
authors.lastname: Anselmo
authors.forename: G
authors.initials: G
authors.lastname: Meloni
authors.forename: E
authors.initials: E
authors.lastname: Cavalieri
authors.forename: A
authors.initials: A
authors.lastname: Proia
authors.forename: R M
authors.initials: RM
authors.lastname: Enrici
authors.forename: D
authors.initials: D
authors.lastname: Funaro
authors.forename: E
authors.initials: E
authors.lastname: Pescarmona
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use / Q000633:toxicity; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D015251:Epirubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000401:mortality; D014182:Transplantation, Autologous
chemical_list: D015251:Epirubicin; D005047:Etoposide; D007069:Ifosfamide