Autologous stem cell transplantation followed by consolidation chemotherapy for relapsed or refractory Hodgkin's lymphoma.

Abstract

Relapse remains a major cause of treatment failure after autotransplantation (auto-PBSCT) for Hodgkin's disease (HD). The administration of non-crossresistant therapies during the post-transplant period may delay or prevent relapse. We prospectively studied the role of consolidation chemotherapy (CC) after auto-PBSCT in 37 patients with relapsed or refractory HD. Patients received high-dose gemcitabine-BCNU-melphalan and auto-PBSCT followed by involved-field radiation and up to four cycles of the DCEP-G regimen, which consisted of dexamethasone, cyclophosphamide, etoposide, cisplatin, gemcitabine given at 3 and 9 months post transplant alternating with a second regimen (DPP) of dexamethasone, cisplatin, paclitaxel at 6 and 12 months post transplant. The probabilities of event-free survival (EFS) and overall survival (OS) at 2.5 years were 59% (95% CI=42-76%) and 86% (95% CI=71-99%), respectively. In all, 17 patients received 54 courses of CC and 15 were surviving event free (2.5 years, EFS=87%). There were no treatment-related deaths during or after the CC phase. Post-transplant CC is feasible and well tolerated. The impact of this approach on EFS should be evaluated in a larger, randomized study.

• Authors: A P Rapoport, C Guo, A Badros, R Hakimian, G Akpek, E Kiggundu, B Meisenberg, H Mannuel, N Takebe, R Fenton, J Bolaños-Meade, M Heyman, I Gojo, K Ruehle, S Natt, B Ratterree, T Withers, C Sarkodee-Adoo, G L Phillips, G Tricot
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 34 Issue 10 Pg. 883-90 (Nov 2004) ISSN: 0268-3369 [Print] England
• PMID: 15517008 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Deoxycytidine
• Etoposide
• Dexamethasone
• Cyclophosphamide
• Cisplatin
• Gemcitabine

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cisplatin (administration & dosage)
• Cyclophosphamide (administration & dosage)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Dexamethasone (administration & dosage)
• Etoposide (administration & dosage)
• Female
• Hematopoietic Stem Cell Transplantation (methods, mortality)
• Hodgkin Disease (mortality, therapy)
• Humans
• Male
• Middle Aged
• Salvage Therapy (methods, mortality)
• Secondary Prevention
• Survival Analysis
• Transplantation, Autologous
• Gemcitabine