TY - JOUR
T1 - Autologous stem cell transplantation for Hodgkin's disease
T2 - Busulfan, melphalan and thiotepa compared to a radiaton-based regimen
AU - Gutierrez-Delgado, F.
AU - Holmberg, L.
AU - Hooper, H.
AU - Petersdorf, S.
AU - Press, O.
AU - Maziarz, R.
AU - Maloney, D.
AU - Chauncey, T.
AU - Appelbaum, F.
AU - Bensinger, W.
PY - 2003/8
Y1 - 2003/8
N2 - 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.
AB - 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.
KW - Autologous
KW - High dose chemotherapy
KW - Hodgkin's disease
KW - Stemcell transplant
KW - Total body irradiation
UR - http://www.scopus.com/inward/record.url?scp=10744229853&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=10744229853&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1704110
DO - 10.1038/sj.bmt.1704110
M3 - Article
C2 - 12858199
AN - SCOPUS:10744229853
SN - 0268-3369
VL - 32
SP - 279
EP - 285
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 3
ER -