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Hodgkin's Disease

Second autologous stem cell transplant for multiply relapsed Hodgkin's disease

Bone Marrow Transplantation volume 29, pages 763–767 (2002)Cite this article

Abstract

Therapeutic options for patients with Hodgkin's disease who relapse after high-dose chemotherapy with autologous stem cell support are limited. Salvage chemotherapy is not curative, and allogeneic stem cell transplantation in this setting is associated with mortality rates of 40–65%. We report our institution's experience with second autologous transplants in this patient population. Five patients (median age 36) with relapsed Hodgkin's disease underwent a second autologous stem cell transplant at a median of 66 months after first transplant. Four patients received CBV, and one patient received BuCy as conditioning. Neutrophil and platelet engraftment occurred by days +10 and +16, respectively. All patients achieved a complete response, and no relapses have occurred after a median follow-up of 42 months. All four patients who received CBV developed interstitial pneumonitis, and two patients died of pulmonary complications 37 and 48 months following second transplant. Three patients remain alive and disease-free 41, 42 and 155 months after second transplant. These data indicate that second autologous transplantation should be considered for selected patients who relapse after a prolonged response to first autologous transplant. However, BCNU pneumonitis is the major toxicity in patients who have undergone previous mantle radiation and received busulfan with first transplant.

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Acknowledgements

The authors wish to thank Dr John C Byrd, for his review of the manuscript, and Ms Michelle Krichbaum, for her assistance in preparation of the manuscript.

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  1. Division of Hematology and Oncology, Arthur James Cancer Hospital and Richard Solove Research Institute at The Ohio State University, Bone Marrow Transplant Program, Columbus, OH, USA

    TS Lin, BR Avalos, SL Penza, G Marcucci, PJ Elder & EA Copelan

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  1. TS Lin
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  2. BR Avalos
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  3. SL Penza
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  6. EA Copelan
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Lin, T., Avalos, B., Penza, S. et al. Second autologous stem cell transplant for multiply relapsed Hodgkin's disease. Bone Marrow Transplant 29, 763–767 (2002). https://doi.org/10.1038/sj.bmt.1703546

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