An update on the management of relapsed and primary refractory Hodgkin's disease.
With the use of combined modality therapy for early stage disease and a risk-adapted approach for advanced stage disease, nearly 90% of patients with Hodgkin's lymphoma are cured with initial therapy. However, in patients who have primary refractory or relapsed disease, high-dose therapy and autologous stem cell transplantation is the best curative option. The use of peripheral blood progenitor cells has decreased transplant related mortality to less than 3%; but long-term progression-free survival as increased minimally. Although prognostic factors have been used to tailor therapy in de novo Hodgkin's lymphoma their utility in the relapsed-refractory setting has not been exploited. This update will discuss these important prognostic factors and try to guide oncologists in treatment decisions in this setting.
Moskowitz
Craig
C
Lymphoma and Hematology Services, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014182:Transplantation, Autologous