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

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

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)279-285
Number of pages7
JournalBone marrow transplantation
Volume32
Issue number3
DOIs
StatePublished - Aug 1 2003

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Keywords

  • Autologous
  • High dose chemotherapy
  • Hodgkin's disease
  • Stemcell transplant
  • Total body irradiation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Gutierrez-Delgado, F., Holmberg, L., Hooper, H., Petersdorf, S., Press, O., Maziarz, R., Maloney, D., Chauncey, T., Appelbaum, F., & Bensinger, W. (2003). Autologous stem cell transplantation for Hodgkin's disease: Busulfan, melphalan and thiotepa compared to a radiaton-based regimen. Bone marrow transplantation, 32(3), 279-285. https://doi.org/10.1038/sj.bmt.1704110