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  • Title: Single and double autotransplants for relapsing/refractory Hodgkin's disease: results of two consecutive trials.
    Author: Ahmed T, Lake DE, Beer M, Feldman EJ, Preti RA, Seiter K, Helson L, Mittelman A, Kancherla R, Ascensao J, Akhtar T, Cook P, Goldberg R, Coleman M.
    Journal: Bone Marrow Transplant; 1997 Mar; 19(5):449-54. PubMed ID: 9052910.
    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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