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Intensive therapy with cyclophosphamide, carmustine, etoposide +/- cisplatin, and autologous bone marrow transplantation for Hodgkin's disease in first relapse after combination chemotherapy [see comments]
| Content Provider | Scilit |
|---|---|
| Author | O'reilly, S. Reece, De Connors, Jm Spinelli, Jj Barnett, Mj Fairey, Rn Klingemann, Hg Nantel, Sh Shepherd, Jd Sutherland, H. J. |
| Copyright Year | 1994 |
| Abstract | The optimal timing in which to use intensive chemotherapy and autologous bone marrow transplantation (BMT) in Hodgkin's disease (HD) is uncertain. In 1985, we initiated a program in which this modality was used as the initial salvage therapy in patients relapsing after combination chemotherapy. Fifty-eight patients with HD in first relapse after primary chemotherapy received conditioning with high-dose cyclophosphamide, carmustine, etoposide (VP16–213) +/- cisplatin (CBV +/- P) followed by autologous BMT. All but six of these patients were given a median of two cycles of conventional chemotherapy +/- involved field radiation therapy before CBV +/- P and autologous BMT. These measures were not used as a means for patients selection; all patients receiving such therapy ultimately were transplanted. The probability of nonrelapse mortality, progression of HD, and progression-free survival post-BMT were calculated, and prognostic factors for progression-free survival were evaluated using the Cox proportional hazards method. Treatment-related deaths occurred in only three patients. Thirteen patients have relapsed at a median 0.7 years (range 0.1 to 3.5) post- BMT. At a median follow-up of 2.3 years (range 0.4 to 7.2), the actuarial progression-free survival is 64% (95% confidence interval, 46% to 78%). In the statistical analysis, three similarly weighted but independent prognostic factors were identified: “B” symptoms at relapse, extranodal disease at relapse, and initial remission duration of less than 1 year. Patients with no risk factors had a 3-year progression-free survival of 100%, compared with 81% in patients with one factor, 40% in those with two factors, and 0% in patients with all three factors. CBV +/- P and autologous BMT is highly effective salvage therapy for HD patients in a first relapse, particularly in the subset of patients with less than two adverse factors. Therapy must be improved in the future for patients with > or = 2 adverse factors. |
| Related Links | https://ashpublications.org/blood/article-pdf/83/5/1193/613846/1193.pdf |
| Ending Page | 1199 |
| Page Count | 7 |
| Starting Page | 1193 |
| DOI | 10.1182/blood.v83.5.1193.1193 |
| Journal | Blood |
| Issue Number | 5 |
| Volume Number | 83 |
| Language | English |
| Publisher | American Society of Hematology |
| Publisher Date | 1994-03-01 |
| Access Restriction | Open |
| Subject Keyword | Hematology Survival Bone Marrow Relapse Optimal Bmt Salvage Therapy Hd Patients Patients Relapsing Journal: Blood (Vol- 83, Issue- 5) |
| Content Type | Text |
| Resource Type | Article |
