Long-Term Effects of High-Dose Chemotherapy and Radiation for Relapsed and Refractory Hodgkin's Lymphoma

Goodman, Karyn A.; Riedel, Elyn; Serrano, Victoria; Gulati, Subhash C.; Moskowitz, Craig H.; Yahalom, Joachim

doi:10.1200/jco.2007.15.5507

Cited by 65 publications

(56 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 Finally, we have proposed that chemosensitive disease should be defined by pretransplant 18 fluorodeoxy glucose-positron emission tomography (FDG-PET) status; those patients with a negative scan have a 5-year EFS of 75% compared with 25% for those patients with improvement of CT but with persistent FDG-PET positivity. [4][5][6][7][8] Similar FDG-PET data were recently confirmed by the transplant group from Washington University. 9 The current comprehensive study incorporates non-cross-resistant SLT and individually tailored RT and HDT/ASCT.…”

Section: Introductionsupporting

confidence: 61%

Normalization of pre-ASCT, FDG-PET imaging with second-line, non–cross-resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma

Moskowitz

Matasar

Zelenetz

et al. 2012

Blood

Self Cite

260

200

View full text Add to dashboard Cite

We previously reported that remission duration < 1 year, extranodal disease, and B symptoms before salvage chemotherapy (SLT) can stratify relapsed or refractory Hodgkin lymphoma (HL) patients into favorable and unfavorable cohorts. In addition, pre-autologous stem cell transplant (ASCT) 18 FDG-PET response to SLT predicts outcome. This phase 2 study uses both pre-SLT prognostic factors and post-SLT FDG-PET response in a risk-adapted approach to improve PFS after high-dose radio-

show abstract

Section: Introductionsupporting

confidence: 61%

Normalization of pre-ASCT, FDG-PET imaging with second-line, non–cross-resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma

Moskowitz

Matasar

Zelenetz

et al. 2012

Blood

Self Cite

260

200

View full text Add to dashboard Cite

show abstract

“…Detailed long-term toxicity associated with high-dose chemotherapy and radiation at our institution was previously reported. 14 This analysis represents the largest series of patients followed prospectively on IRB approved trials and treated with uniform ST. Consistent with other reports, the outcome for FI-positive patients is poor with median EFS of 11 months and 5-year EFS of 31%.…”

mentioning

confidence: 99%

Pretransplantation functional imaging predicts outcome following autologous stem cell transplantation for relapsed and refractory Hodgkin lymphoma

Moskowitz

Yahalom

Kewalramani

et al. 2010

Blood

Self Cite

216

149

View full text Add to dashboard Cite

To identify prognostic factors for patients transplanted for relapsed or refractory Hodgkin lymphoma we carried out a combined analysis of patients followed prospectively on 3 consecutive protocols at Memorial Sloan-Kettering Cancer Center. One hundred fifty-three patients with chemosensitive disease after ICE (ifosfamide, carboplatin, and etoposide)-based salvage therapy (ST) proceeded to highdose chemoradiotherapy followed by au- IntroductionThe standard treatment for relapsed or refractory (rel/ref) Hodgkin lymphoma (HL) is high-dose chemoradiotherapy followed by autologous stem cell transplantation (ASCT) 1,2 ; this treatment cures approximately 50% of patients. 2-4 Eligibility for ASCT is based upon the presence of chemosensitive disease to salvage therapy (ST) on computed tomography (CT). While many patients are evaluated by both CT and fluorodeoxyglucose-positron emission tomography (FDG-PET) prior to ASCT, it is currently standard practice for FDG-PET-positive patients to proceed to transplantation as long as they show evidence of response to ST on CT. FDG-PET is now an integral component of the response assessment for HL, and it has been shown to be prognostic at interim analysis during front-line treatment 5,6 as well as prior to ASCT. [7][8][9][10][11][12] Since 1994, patients with rel/ref HL presenting to our institution were treated on 1 of 3 consecutive studies and received ICE (ifosfamide, carboplatin, etoposide)-based ST followed by ASCT. All patients were evaluated before ST and ASCT with CT and functional imaging (FDG-PET or gallium). We aimed to determine the prognostic impact of functional imaging (FI) and other factors on outcome following ASCT in this group, which represents the largest series of patients receiving ICE-based ST before ASCT. Methods STAll patients received ICE-based ST followed by ASCT on 1 of 3 consecutive protocols or as per protocol. Treatment details were previously described. 3,13 In brief, patients treated from 1994 to 1998 received 2 cycles of standard ICE and patients treated from 1998 to 2003 received riskstratified ST based upon the number of pre-ST risk factors (RFs; B symptoms, extranodal disease, and/or remission duration less than 1 year) present. Patients with 0-1 RF received standard-ICE, those with 2 RFs received 1 cycle of standard ICE and 1 cycle of augmented ICE, and those with 3 RFs received high-dose ICE with autologous stem cell rescue. Patients were evaluated by FI (either gallium or FDG-PET) and CT prior to ST and prior to ASCT; those with at least minimal response to ST proceeded to ASCT. Conditioning regimensConditioning consisted of total lymphoid irradiation plus high-dose cyclophosphamide and etoposide for radiation-naive patients or CBV (cyclophosphamide, BCNU, and etoposide) for those previously irradiated. Involved field radiation therapy (IFRT) was administered prior to ASCT to all sites of residual or relapsed nodal-based disease that were not previously irradiated. Patients received up to 3600 cGy radiation (combined IFRT and total lymph...

show abstract

“…Concerning the cumulative incidence of SPM, data from retrospective studies are difficult to interpret because of differences in median follow-up, selection of patients (all transplanted patients or only patients who survived ≥2 years after ASCT), period of inclusion, number of treatment lines before ASCT, heterogeneity of treatments, conditioning regimens and source of stem-cells. 7,[17][18][19] Given this, the cumulative incidences of SPM in retrospective studies ranged from 5.8% to 14.7% at 10 years, and from 8% to 15.3% at 15 years. In the present study, considering patients who did not relapse after completing single ASCT (intermediate-risk group), the 10-and 15-year cumulative incidences of SPM were 16% and 24%, respectively, which are higher than in retrospective studies.…”

Section: A B D Cmentioning

confidence: 99%

“…[10][11][12][13][14][15][16] In contrast, only a few retrospective studies have addressed long-term effects after ASCT for relapsed or refractory HL. 17,18 Thus, long-term prospective data are lacking for first-relapsed or refractory HL treated with ASCT. Concerning the cumulative incidence of SPM, data from retrospective studies are difficult to interpret because of differences in median follow-up, selection of patients (all transplanted patients or only patients who survived ≥2 years after ASCT), period of inclusion, number of treatment lines before ASCT, heterogeneity of treatments, conditioning regimens and source of stem-cells.…”

Section: A B D Cmentioning

confidence: 99%

Single or tandem autologous stem-cell transplantation for first-relapsed or refractory Hodgkin lymphoma: 10-year follow-up of the prospective H96 trial by the LYSA/SFGM-TC study group

et al. 2015

View full text Add to dashboard Cite

Long-Term Effects of High-Dose Chemotherapy and Radiation for Relapsed and Refractory Hodgkin's Lymphoma

Abstract: HL accounts for most deaths among patients surviving HDT and ASCR. Survivors of ASCR had an elevated risk of SM compared with the cancer risk in the general population, but when compared with patients with HL in SEER, the risk was less pronounced.

Cited by 65 publications

References 40 publications

Normalization of pre-ASCT, FDG-PET imaging with second-line, non–cross-resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma

Normalization of pre-ASCT, FDG-PET imaging with second-line, non–cross-resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma

Pretransplantation functional imaging predicts outcome following autologous stem cell transplantation for relapsed and refractory Hodgkin lymphoma

Single or tandem autologous stem-cell transplantation for first-relapsed or refractory Hodgkin lymphoma: 10-year follow-up of the prospective H96 trial by the LYSA/SFGM-TC study group

Contact Info

Product

Resources

About