BACKGROUND: The best results of conventional-dose salvage chemotherapy for Hodgkin's disease have been reported after first relapse. We evaluated the results of high-dose chemotherapy and autologous hematopoietic rescue for Hodgkin's disease patients who had relapsed from an initial chemotherapy-induced complete remission. PATIENTS AND METHODS: Eighty-five patients received high-dose cyclophosphamide, carmustine, and etoposide (CBV) followed by autologous bone marrow or peripheral blood stem cell transplantation. RESULTS: Actuarial survival at five years was 51%, and failure-free survival was 40%. Failure-free survival at five years was 90% for patients who received no conventional-dose salvage chemotherapy prior to CBV. Failure-free survival of patients treated initially with a four-drug regimen was not significantly different than patients treated with seven/eight-drug regimens. CONCLUSION: These results appear to be better than those reported for conventional-dose salvage chemotherapy. High-dose therapy followed by autologous bone marrow or peripheral blood stem cell transplantation should be considered for any patient with relapsed Hodgkin's disease, regardless of the length of initial remission, or type of initial chemotherapy. Certain patients, especially those with minimal disease, may benefit by proceeding directly to transplantation after relapse, without first receiving conventional-dose salvage chemotherapy.
BACKGROUND: The best results of conventional-dose salvage chemotherapy for Hodgkin's disease have been reported after first relapse. We evaluated the results of high-dose chemotherapy and autologous hematopoietic rescue for Hodgkin's diseasepatients who had relapsed from an initial chemotherapy-induced complete remission. PATIENTS AND METHODS: Eighty-five patients received high-dose cyclophosphamide, carmustine, and etoposide (CBV) followed by autologous bone marrow or peripheral blood stem cell transplantation. RESULTS: Actuarial survival at five years was 51%, and failure-free survival was 40%. Failure-free survival at five years was 90% for patients who received no conventional-dose salvage chemotherapy prior to CBV. Failure-free survival of patients treated initially with a four-drug regimen was not significantly different than patients treated with seven/eight-drug regimens. CONCLUSION: These results appear to be better than those reported for conventional-dose salvage chemotherapy. High-dose therapy followed by autologous bone marrow or peripheral blood stem cell transplantation should be considered for any patient with relapsed Hodgkin's disease, regardless of the length of initial remission, or type of initial chemotherapy. Certain patients, especially those with minimal disease, may benefit by proceeding directly to transplantation after relapse, without first receiving conventional-dose salvage chemotherapy.
Authors: Jacob P Smeltzer; Amanda F Cashen; Qin Zhang; Andrew Homb; Farrokh Dehdashti; Camille N Abboud; John F Dipersio; Keith E Stockerl-Goldstein; Geoffrey L Uy; Ravi Vij; Peter Westervelt; Nancy L Bartlett; Todd A Fehniger Journal: Biol Blood Marrow Transplant Date: 2011-05-03 Impact factor: 5.742
Authors: Richard T Hoppe; Ranjana H Advani; Weiyun Z Ai; Richard F Ambinder; Patricia Aoun; Celeste M Bello; Cecil M Benitez; Philip J Bierman; Kristie A Blum; Robert Chen; Bouthaina Dabaja; Andres Forero; Leo I Gordon; Francisco J Hernandez-Ilizaliturri; Ephraim P Hochberg; Jiayi Huang; Patrick B Johnston; Nadia Khan; David G Maloney; Peter M Mauch; Monika Metzger; Joseph O Moore; David Morgan; Craig H Moskowitz; Carolyn Mulroney; Matthew Poppe; Rachel Rabinovitch; Stuart Seropian; Christina Tsien; Jane N Winter; Joachim Yahalom; Jennifer L Burns; Hema Sundar Journal: J Natl Compr Canc Netw Date: 2015-05 Impact factor: 11.908
Authors: Richard E Harris; Amanda M Termuhlen; Lynette M Smith; James Lynch; Michael M Henry; Sherrie L Perkins; Thomas G Gross; Phyllis Warkentin; Adrianna Vlachos; Lauren Harrison; Mitchell S Cairo Journal: Biol Blood Marrow Transplant Date: 2010-07-15 Impact factor: 5.742
Authors: Craig H Moskowitz; Joachim Yahalom; Andrew D Zelenetz; Zhigang Zhang; Daniel Filippa; Julie Teruya-Feldstein; Tarun Kewalramani; Alison J Moskowitz; Robert David Rice; Jocelyn Maragulia; Jill Vanak; Tanya Trippett; Paul Hamlin; Steven Horowitz; Ariela Noy; Owen A O'Connor; Carol Portlock; David Straus; Stephen D Nimer Journal: Br J Haematol Date: 2010-01-18 Impact factor: 6.998