title: Successful outcome of patients with relapsed/refractor Hodgkin lymphoma treated with high dose chemotherapy at the National Adult Bone Marrow Transplant Unit at St. James's Hospital.
abstract: Patients with Hodgkin lymphoma who relapse or are refractory to first line multi-agent chemotherapy can be successfully salvaged with high dose therapy (HDT) and autologous stem cell transplant (ASCT). Twenty-six patients with relapsed or refractory Hodgkin lymphoma have been treated with HDT and ASCT at St James Hospital between 2000 and 2005. At day 100 post HDT-ASCT, 23 patients were in complete remission. This group included all 6 patients transplanted at first relapse, 8 of 9 with advanced disease and 9 of 11 with primary refractory disease. Patients treated in first relapse had the best outcome with an overall and progression free survival of 100% (median, 37 months). Patients with primary refractory disease had the poorest outcome with an overall survival of 76% (median, 28 months). All patients with primary refractory disease responsive to salvage chemotherapy were in remission at a median of 28 months. The presence of chemosensitive disease prior to transplantation was the most important determinant of outcome. PET-CT imaging is useful to assess chemosensititvity prior to HDT and thus predict which patients will do well post HDT-ASCT. No patient died of treatment related toxicity. The outcome of this patient series compares favourably with international figures.
authors.affiliation: Department of Haematology, St James's Hospital, James's Street, Dublin. laurencebacon@yahoo.co.uk
authors.forename: C L
authors.initials: CL
authors.lastname: Bacon
authors.forename: P
authors.initials: P
authors.lastname: Daly
authors.forename: B
authors.initials: B
authors.lastname: Sheane
authors.forename: E C
authors.initials: EC
authors.lastname: Conneally
authors.forename: P V
authors.initials: PV
authors.lastname: Browne
authors.forename: S
authors.initials: S
authors.lastname: McCann
authors.forename: M
authors.initials: M
authors.lastname: Ni Chongaile
authors.forename: D S
authors.initials: DS
authors.lastname: O'Brian
authors.forename: R
authors.initials: R
authors.lastname: Mc Dermott
authors.forename: D
authors.initials: D
authors.lastname: Hollywood
authors.forename: L
authors.initials: L
authors.lastname: Wilson
authors.forename: E
authors.initials: E
authors.lastname: Vandenberghe
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D012074:Remission Induction; D016879:Salvage Therapy; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014182:Transplantation, Autologous; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents