title: Treatment for primary refractory Hodgkin's disease: a comparison of high-dose chemotherapy followed by ASCT with conventional therapy.
abstract: Our previously published study showed promising results of autologous stem cell transplantation (ASCT) in patients with primary resistant Hodgkin's disease (HD). Probabilities of overall survival (OS) and progression-free survival (PFS) at 3 years were 55 and 36%, respectively. The present study was undertaken to compare these results with conventionally treated patients and thus evaluate therapeutic options. Retrospective data on 76 adult patients who underwent ASCT were matched with 76 conventionally treated patients from 17 centers. Comparison of clinical characteristics in both groups showed that ASCT patients were younger (24 vs 31.5 years, P=0.001), more frequently presented with 'B' symptoms (P=0.03) and that more patients treated with chemotherapy (CT) had elevated LDH (P=0.03). In univariate analyses, bulky disease (P=0.0043) and complete resistance to standard CT (P=0.051) were found to be risk factors for OS. In a multivariate survival analysis only bulky disease was found to an independent prognostic factor (P=0.005). There was no difference in survival between the treatment groups with 5 years OS 33.7 (CI: 23-46) in the ASCT group and 35.6% (CI: 25-50) for the CT group (P=0.92). We conclude that ASCT is not superior to standard CT for treatment of patients with primary refractory HD.
authors.affiliation: Medical University of Gdansk, Poland. jczyz@amg.gda.pl
authors.forename: J
authors.initials: J
authors.lastname: Czyz
authors.forename: R
authors.initials: R
authors.lastname: Szydlo
authors.forename: W
authors.initials: W
authors.lastname: Knopinska-Posluszny
authors.forename: A
authors.initials: A
authors.lastname: Hellmann
authors.forename: J
authors.initials: J
authors.lastname: Gozdzik
authors.forename: J
authors.initials: J
authors.lastname: Hansz
authors.forename: P
authors.initials: P
authors.lastname: Smolewski
authors.forename: T
authors.initials: T
authors.lastname: Robak
authors.forename: M
authors.initials: M
authors.lastname: Osowiecki
authors.forename: J
authors.initials: J
authors.lastname: Walewski
authors.forename: A
authors.initials: A
authors.lastname: Avigdor
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.forename: T
authors.initials: T
authors.lastname: Zemelka
authors.forename: M
authors.initials: M
authors.lastname: Pawlicki
authors.forename: Z
authors.initials: Z
authors.lastname: Sawicki
authors.forename: M
authors.initials: M
authors.lastname: Wojtukiewicz
authors.forename: L
authors.initials: L
authors.lastname: Kachel
authors.forename: J
authors.initials: J
authors.lastname: Holowiecki
authors.forename: G
authors.initials: G
authors.lastname: Charlinski
authors.forename: W W
authors.initials: WW
authors.lastname: Jedrzejczak
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000401:mortality; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods; D016019:Survival Analysis; D019172:Transplantation Conditioning