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Hodgkin's disease

Autologous stem cell transplantation for Hodgkin's disease: busulfan, melphalan and thiotepa compared to a radiation-based regimen

Bone Marrow Transplantation volume 32, pages 279–285 (2003)Cite this article

Summary:

We evaluated prognostic factors and treatment outcome of patients with relapsed/refractory Hodgkin's disease (HD) receiving autologous stem cell transplantation (ASCT). In total, 92 patients received total body irradiation, cyclophosphamide and etoposide (TBI/CY/E) (n=42) or busulfan, melphalan and thiotepa (Bu/Mel/T) (n=50) supported with ASCT. A total of 33 (66%) patients receiving the Bu/Mel/T regimen had a prior history of dose-limiting irradiation. Mucositis, hepatic and pulmonary toxicities were the main causes of morbidity and mortality, irrespective of the conditioning regimen. The transplant-related mortality was 15%. With a median follow-up of 6 years (range 2.5–11), the cumulative probabilities of survival, event-free survival (EFS) and relapse at 6 years were 55, 51 and 32%. The 6-year Kaplan–Meier (KM) probabilities of EFS for patients with less advanced disease (patients in first chemotherapy-responsive relapse or second remission (n=42)) and more advanced disease (all other patients (n=50)) were 60 and 44%. No differences in toxicities and efficacy between the conditioning regimens were found. ASCT is an effective treatment for patients with refractory/relapsed HD. Female patients and patients with less advanced disease at transplant had a better outcome. Patients with prior irradiation benefited from the Bu/Mel/T regimen.

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Acknowledgements

Supported by grants from the National Institutes of Health CA 18029, CA 47748, CA 15704 and the Jose Carreras Foundation against Leukemia. FG-D was supported by a grant from Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.

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  1. Fred Hutchinson Cancer Research, Veterans Administration Hospital, University of Washington and Puget Sound Oncology Consortium, Seattle, WA, USA

    F Gutierrez-Delgado, L Holmberg, H Hooper, S Petersdorf, O Press, R Maziarz, D Maloney, T Chauncey, F Appelbaum & W Bensinger

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Gutierrez-Delgado, F., Holmberg, L., Hooper, H. et al. Autologous stem cell transplantation for Hodgkin's disease: busulfan, melphalan and thiotepa compared to a radiation-based regimen. Bone Marrow Transplant 32, 279–285 (2003). https://doi.org/10.1038/sj.bmt.1704110

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