Role of chemoresistance prior to autologous bone marrow transplantation for Hodgkin's disease.

In the present study, the response to last salvage chemotherapy was analysed in a series of 30 patients with poor prognosis Hodgkin's disease having received high dose chemotherapy followed by autologous bone marrow transplantation. The probability of survival was 43% at 152 months for the 21 chemosensitive patients as compared to 11% at 36 months for the 9 chemoresistent patients. Two toxic deaths occurred, both in the group of chemoresistant subjects, while the probability of absence of disease progression was 65% at 152 months in the 21 chemosensitive cases. According to these results, the response to the last conventional therapy before grafting is an important prognostic factor for survival and absence of disease progression after transplantation. Patients with chemoresistant Hodgkin's disease should benefit from new therapeutic approaches in the context of phase I or II clinical trials.