Autografting For Lymphoma

Single and double autotransplants for relapsing/refractory Hodgkin’s disease: results of two consecutive trials

Abstract

To evaluate a strategy of one cycle of dose-intensive chemotherapy for patients with Hodgkin’s disease in sensitive relapse and two cycles for those with refractory disease, 122 patients received dose-intensive chemotherapy followed by autotransplant in two consecutive studies. Patients with refractory disease were offered a second transplant with different conditioning in the absence of progression or excessive toxicity. CR was present after treatment in 46% while 16% died in the peritransplant period. Of 41 patients with primary refractory disease and 42 with refractory relapse, 24 and 21 respectively received a second cycle. Of these 45 refractory patients, 12 were in CR and 11 in PR after the first cycle and 10 of these 11 in PR achieved a durable CR with the second transplant. The CR rate is 37% in patients with refractory relapse and 19% in those with primary refractory disease. At a median follow-up of 4 years, median survival is 45 months. Progression-free survival of the refractory patients who could receive a second cycle was similar to that of patients with sensitive disease. A sequential transplant strategy is feasible. A subgroup of patients with refractory disease can achieve long-term survival after sequential BMT.

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Correspondence to T Ahmed.

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Ahmed, T., Lake, D., Beer, M. et al. Single and double autotransplants for relapsing/refractory Hodgkin’s disease: results of two consecutive trials. Bone Marrow Transplant 19, 449–454 (1997) doi:10.1038/sj.bmt.1700682

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Keywords

  • Hodgkin’
  • s disease
  • double transplant
  • dose-intensive therapy
  • refractory disease

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