Autotransplantation for relapsed or refractory Hodgkin's disease: Long-term follow-up and analysis of prognostic factors

J. E. Lancet, A. P. Rapoport*, R. Brasacchio, S. Eberly, R. F. Raubertas, T. Linder, A. Muhs, R. E. Duerst, C. N. Abboud, C. H. Packman, J. F. Dipersio, L. S. Constine, J. M. Rowe, J. L. Liesveld

*Corresponding author for this work

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

Seventy consecutive patients with refractory or relapsed Hodgkin's disease who received high-dose chemotherapy followed by autologous stem cell rescue were analyzed to identify clinically relevant predictors of long-term event-free survival. High-dose therapy consisted primarily of carmustine (BCNU), etoposide, cytarabine and cyclophosphamide (BEAC). The 5-year Kaplan-Meier event-free survival (EFS) for the entire cohort was 32% (95% confidence interval; 18-45%) with a median follow-up of 3.6 years (range 7 months-7.6 years). The most significant predictor of improved survival was the presence of minimal disease (defined as all areas ≤ 2 cm) at the time of transplant: the 5 years EFS was 46 vs 10% for patients with bulky disease (P = 0.0002). Other independent predictors identified by step-wise regression analysis included the presence of non-refractory disease and the administration of post-transplant involved-field radiotherapy (XRT). Treatment-related mortality occurred in 13 of 70 patients: nine patients (13%) died within the first 100 days, mainly from cardiopulmonary toxicity. However, only one of 24 patients (4%) transplanted during the last 4.5 years died from early treatment-related complications. While high-dose therapy followed by autotransplantation led to long-term EFS of 50% for patients with favorable prognostic factors, a substantial proportion of patients relapsed, indicating that new therapeutic strategies are needed.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalBone Marrow Transplantation
Volume22
Issue number3
DOIs
StatePublished - Jan 1 1998

Keywords

  • Autotransplantation
  • High-dose chemotherapy
  • Hodgkin's disease
  • Prognostic factors
  • Radiotherapy

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Lancet, J. E., Rapoport, A. P., Brasacchio, R., Eberly, S., Raubertas, R. F., Linder, T., Muhs, A., Duerst, R. E., Abboud, C. N., Packman, C. H., Dipersio, J. F., Constine, L. S., Rowe, J. M., & Liesveld, J. L. (1998). Autotransplantation for relapsed or refractory Hodgkin's disease: Long-term follow-up and analysis of prognostic factors. Bone Marrow Transplantation, 22(3), 265-271. https://doi.org/10.1038/sj.bmt.1701325