High dose chemotherapy followed by autologous stem cell transplantation for relapsed or refractory Hodgkin’s lymphoma

Holland, Derek; Engelhardt, Brian G.; Goodman, Stacey; Greer, John P.; Morgan, David S.; Schuening, Friedrich; Wolff, Steven N.; Bitting, Rhonda L.; Sulur, Paulgun; Stein, Richard S.

doi:10.1200/jco.2006.24.18_suppl.7552

Cited by 2 publications

(1 citation statement)

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“…The most important clinical factor for long-term survival after stem cell transplantation is duration of prior complete response. In an abstract from the American Society of Clinical Oncology in 2006 [30], a retrospective chart review of 115 patients who underwent autologous transplantation was conducted. The 5-year survival of patients with a complete response to chemotherapy lasting greater than 12 months was 63%.…”

Section: Autologous Transplantationmentioning

confidence: 99%

Salvage Therapy in Hodgkin's Lymphoma

Byrne

Gockerman

2007

The Oncologist

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Hodgkin's disease is a rare malignancy that affects approximately 7,500 patients per year in the U.S., leading to an estimated 1,400 deaths. The relapse rate for this disease varies from around 5% for early-stage disease to 35% for patients with advanced disease. Patients who relapse after chemotherapy have about a 20% cure rate with conventional salvage chemotherapy. Two randomized phase III studies have shown an improved failure-free survival rate with high-dose chemotherapy and autologous stem cell support compared with conventional chemotherapy in re- CASE PRESENTATIONMr. T is a 50-year-old African-American male with a past medical history significant for type 2 diabetes mellitus. In January 2002, he presented to the emergency room with complaints of fever, chills, right groin pain, and a 25-pound weight loss over the last several months. Initial laboratory evaluation revealed an elevated white cell count of 11,800, hemoglobin of 11.7 g/dl, hematocrit of 35.8, platelet count of 406,000, and an elevated blood sugar of 516 mg/dl. A chest radiograph revealed right paratracheal lymphadenopathy and a patchy density overlying the left upper lung field. A computed tomography (CT) scan of the chest, abdomen, and pelvis showed enlarged lymph nodes in the mediastinum and the prevascular, right paratracheal, subcarinal, left axillary, left subclavian, azygoesophageal recess, and inguinal and bilateral iliac regions. A biopsy of the enlarged right cervical lymph node revealed fibrofatty connective tissue. A mediastinoscopy with biopsy was performed, and the pathology revealed mixed cellularity-type Hodgkin's lymphoma (Fig. 1). A gallium scan was positive in the mediastinal, left axillary, and right inguinal nodes. A bone marrow biopsy revealed Hodgkin's lymphoma, and the patient was considered to have clinical-stage IVB disease (Fig. 2). He underwent treatment with adriamycin, bleomycin, vincristine, and dacarbazine (ABVD) chemotherapy for four cycles. Restaging gallium scan was negative for nodal uptake, and a CT scan showed significant decrease in the lymphadenopathy. After four additional cycles of ABVD, repeat staging revealed new gallium-avid disease in the right paratracheal region, with stable disease upon CT scan. Repeat bone marrow biopsy was negative. The patient was considered to have refractory disease and underwent salvage therapy with rituximab, ifosfamide, carboplatin, and etoposide. After two cycles, he had a negative gallium

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Section: Autologous Transplantationmentioning

confidence: 99%