title: High-dose therapy and autologous stem cell transplantation in relapsed and refractory Hodgkin's disease: outcome based on a prognostic model.
abstract: We evaluated the results of high-dose therapy (HDT) and autologous hematopoietic stem cell transplantation (ASCT) in patients with relapsed or primary refractory Hodgkin's disease (HD), using a previously reported prognostic model based on the presence of three poor prognostic factors at the start of salvage therapy/preparative regimen: B symptoms, extranodal disease and the duration of last complete response of less than 1 year. Based on this model, the patients were divided into low-risk and high-risk groups. Between 1993 and 2001, 24 patients with HD were treated with HDT and ASCT. Eighteen of the 24 patients had 0-1 risk factors (low-risk group) and 6 patients had 2-3 risk factors (high-risk group). Using Kaplan-Meier analysis, after a median follow-up of 40.5 months, the progression-free survival (PFS) was 48%, and the overall survival (OS) was 55%. PFS in the low-risk group was 56%, and in the high-risk group 17% (p < 0.001). OS in the low-risk group was 68% and in the high-risk group it was 18% (p < 0.001). The 100-day transplant-related mortality for the entire group was 16%. Our results are comparable to those reported in previous clinical trials for patients with refractory and relapsed HD treated with HDT and ASCT. The use of a prognostic model appears useful for predicting the outcome of HDT and ASCT for HD patients, and may play an important role in choosing the appropriate therapy for these patients.
authors.affiliation: Blood and Marrow Transplantation Program, West Virginia University, Morgantown, W.Va., USA. mqazilba@mdanderson.org
authors.forename: Muzaffar H
authors.initials: MH
authors.lastname: Qazilbash
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Devetten
authors.forename: Jame
authors.initials: J
authors.lastname: Abraham
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Lynch
authors.forename: Charles L
authors.initials: CL
authors.lastname: Beall
authors.forename: Miklos
authors.initials: M
authors.lastname: Auber
authors.forename: Robin
authors.initials: R
authors.lastname: Weisenborn
authors.forename: Pam
authors.initials: P
authors.lastname: Bunner
authors.forename: Solveig G
authors.initials: SG
authors.lastname: Ericson
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D033581:Stem Cell Transplantation / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D005047:Etoposide; D003520:Cyclophosphamide; D002330:Carmustine