title: Treatment strategy based on gemcitabine-containing salvage chemotherapy used with intent to proceed to second stem cell transplant for patients with Hodgkin lymphoma relapsing after a prior autologous transplant.
abstract: This report is an analysis of patients with Hodgkin lymphoma who relapsed after autologous stem cell transplant (autoHCT) and who were treated with gemcitabine-based therapy as a bridge to either allogeneic or second autologous transplant. Sixteen patients were treated with gemcitabine, cisplatin and steroid and 21 with gemcitabine plus vinorelbine. The overall response rate was 68%. The grade 3-4 toxicity was myelosupression and infections. Fifteen patients proceeded to allogeneic and five to autologous transplant. Two-year overall survival (OS) and progression-free survival (PFS) for all patients were 36% and 25%, respectively. In multivariate analysis, relapse > 6 months after autoHCT and response to gemcitabine-based chemotherapy were associated with superior OS and response to gemcitabine-based chemotherapy with improved PFS. A treatment strategy based on gemcitabine-containing chemotherapy and second transplant appears to be an effective treatment option for patients relapsing > 6 months after autoHCT, providing a median survival time of 34 months.
authors.affiliation: Department of Hematology, Poznan University of Medical Sciences, Poznan, Poland. aczyz@onet.eu
authors.forename: Anna
authors.initials: A
authors.lastname: Czyz
authors.forename: Joanna
authors.initials: J
authors.lastname: Romejko-Jarosinska
authors.forename: Wanda
authors.initials: W
authors.lastname: Knopinska-Posluszny
authors.forename: Adam
authors.initials: A
authors.lastname: Nowicki
authors.forename: Anna
authors.initials: A
authors.lastname: Lojko-Dankowska
authors.forename: Lidia
authors.initials: L
authors.lastname: Gil
authors.forename: Dominik
authors.initials: D
authors.lastname: Dytfeld
authors.forename: Jan
authors.initials: J
authors.lastname: Walewski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Hellmann
authors.forename: Mieczyslaw
authors.initials: M
authors.lastname: Komarnicki
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012008:Recurrence; D016879:Salvage Therapy; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D000093542:Gemcitabine