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Autotransplants for Hodgkin’s disease in first relapse or second remission: a report from the autologous blood and marrow transplant registry (ABMTR).
- Source :
- Bone Marrow Transplantation; 2/15/2001, Vol. 27 Issue 4, p387, 10p
- Publication Year :
- 2001
-
Abstract
- Although patients with relapsed Hodgkin’s disease have a poor prognosis with conventional therapies, high-dose chemotherapy and autologous hematopoietic stem cell transplantation (autotransplantation) may provide long-term progression-free survival. We reviewed data from the Autologous Blood and Marrow Transplant Registry (ABMTR) to determine relapse, disease-free survival, overall survival, and prognostic factors in this group of patients. Detailed records from the ABMTR on 414 patients with Hodgkin’s disease in first relapse (n = 295) or second complete remission (CR) (n = 119) receiving an autotransplant from 1989 to 1995 were reviewed. Median age was 29 (range, 7–64) years. Median time from diagnosis to relapse was 18 (range, 6–219) months; median time from relapse to transplant was 5 (range, <1–215) months. Most patients received high-dose chemotherapy without total body irradiation for conditioning (n = 370). The most frequently used high-dose regimen was cyclophosphamide, BCNU, VP-16 (CBV) (n = 240). The graft consisted of bone marrow (n = 246), blood stem cells (n = 112), or both (n = 56). Median follow-up was 46 (range, 5–96) months. One hundred-day mortality (95% confidence interval) was 7 (5–9)%. One hundred and sixty-five of 295 patients (56%) transplanted in relapse achieved CR after autotransplantation. Of these, 61 (37%) recurred. Twenty-four of 119 patients (20%) transplanted in CR recurred. The probability of disease-free survival at 3 years was 46 (40–52)% for transplants in first relapse and 64 (53–72)% for those in second remission (P < 0.001). Overall survival at 3 years was 58 (52–64)% after transplantation in first relapse and 75 (66–83)% after transplantation in second CR (P < 0.001). In multivariate analysis, Karnofsky performance score <90% at transplant, abnormal serum LDH at transplant, and chemotherapy resistance were adverse prognostic factors for outcome.... [ABSTRACT FROM AUTHOR]
- Subjects :
- AUTOTRANSPLANTATION
HODGKIN'S disease
AUTOGRAFTS
BONE marrow transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 02683369
- Volume :
- 27
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Bone Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 8888916
- Full Text :
- https://doi.org/10.1038/sj.bmt.1702796