High-dose chemotherapy plus non-cryopreserved autologous peripheral blood stem cell transplantation rescue for patients with refractory or relapsed Hodgkin disease.
A simplified schedule of high-dose chemotherapy consisting of cyclophosphamide (60 mg.kg(-1).d(-1) for 2 days), etoposide (15 mg.kg(-1).d(-1) for 2 days), and carboplatin (400 mg/m(2) per day for 2 days) plus autologous non-cryopreserved peripheral blood stem cells (PBSCs) was used for treatment of patients with relapsed (n = 25) and refractory (n = 3) Hodgkin disease. The use of such PBSCs mobilized by granulocyte colony-stimulating factor after high-dose myeloablative therapy resulted in a rapid, complete, and sustained hematopoietic recovery. The median time to achieve an absolute neutrophil count >0.5 x 10(9)/L was 13 days (range, 7-18 days). The median time to a self-sustained platelet count >20 x 10(9)/L was 15 days (range, 7-20 days). Twelve of the 28 patients (43%) were alive and without disease at a median follow-up of 16 months (range, 9-86 months) for all surviving patients. The estimated 2-year overall survival and disease-free survival for all patients were 45% and 42%, respectively. Thirteen patients died of relapse or progressive disease, 2 died of infection, and 1 was still surviving in relapse by the time of the analysis. The median time to relapse was 10 months (range, 3-28 months) from PBSC infusion. High-dose chemotherapy with short-duration chemotherapy and non-cryopreserved bone marrow is an effective and safe treatment modality for patients with relapsed or resistant Hodgkin lymphoma.
Mabed
Mohamed
M
Hematology and Medical Oncology Unit, Mansoura University, Mansoura, Egypt. mohmabed@mans.edu.eg <mohmabed@mans.edu.eg>
Shamaa
Sameh
S
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D015925:Cryopreservation; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous
D005047:Etoposide; D003520:Cyclophosphamide; D016190:Carboplatin