title: Hematopoietic progenitor cells transplantation for recurrent or refractory Hodgkin's lymphoma.
abstract: BACKGROUND
  Advanced-stage Hodgkin's lymphoma (HL) has become a curable disease in the majority of patients. Despite this, about 20% of these patients relapsed or are primary refractory to the first-line treatment and high-dose chemotherapy (HDC) and autologous (Auto) hematopoietic progenitor cells transplantation (HPCT) are considered a therapeutic option.
  
  
  METHODS
  The authors reviewed HDC and HPCT treatment strategies in recurrent or refractory HL patients, with the goal of providing an overview of this approach.
  
  
  CONCLUSIONS
  Patients younger than 60-65 years with relapsed disease or refractory to first-line therapy should receive a second-line chemotherapy, followed by HDC and Auto-HPCT. Progression-free and overall survival results are significantly better when a second remission or a minimal disease status is achieved before Auto-HPCT, and demonstrate that this strategy is able to cure more than half of the advanced HL patients. Myeloablative allogeneic HPCT (Allo-HPCT) has been employed in advanced phases of the disease, but there have been significant concerns due to treatment-related mortality (TRM). The safety of allogeneic transplantation has improved with the use of reduced-intensity allogeneic (RIC-Allo) HPCT strategies. Despite early favorable results, mature results of RIC-Allo available in the literature are consistent in demonstrating a lack of long-term disease control.
authors.affiliation: Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera BMM, Via Melacrino n.1, 89100 Reggio Calabria, Italy. timoscato@yahoo.it
authors.forename: Tiziana
authors.initials: T
authors.lastname: Moscato
authors.forename: Roberta
authors.initials: R
authors.lastname: Fedele
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Messina
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Irrera
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Console
authors.forename: Massimo
authors.initials: M
authors.lastname: Martino
mesh_terms: D019008:Drug Resistance, Neoplasm; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000628:therapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000628:therapy*