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

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. Philips, G. Tricot

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)883-890
Number of pages8
JournalBone marrow transplantation
Volume34
Issue number10
DOIs
StatePublished - Nov 2004

Keywords

  • Auto-PBSCT
  • Autotransplantation
  • Consolidation chemotherapy
  • Gemcitabine
  • High-dose therapy
  • Hodgkin's disease
  • PBSCT

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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