Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting.

Lister, T. A.; Crowther, Derek; Sutcliffe, S B; Glatstein, Eli; Gp, Canellos; Young, Robert C.; Rosenberg, S A; Coltman, Charles A.; Tubiana, M

doi:10.1200/jco.1989.7.11.1630

Cited by 1,463 publications

(798 citation statements)

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“…The RECIST criteria were chosen because of the heterogeneity of the patient population, which included both patients with HL and NHL, as well as those with visceral disease. In these patients, neither the Cotswold criteria (Lister et al, 1989) nor the International Workshop NHL response criteria (Cheson et al, 1999) could be strictly applied.…”

Section: Evaluation Of Responsementioning

confidence: 99%

Gemcitabine, cisplatin and methylprednisolone (GEM-P) is an effective salvage regimen in patients with relapsed and refractory lymphoma

Waters

Cunningham

et al. 2005

Br J Cancer

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There is currently no standard salvage chemotherapy regimen in relapsed and refractory lymphoma. Gemcitabine is a novel nucleoside analogue, which acts synergistically with cisplatin both in vitro and in clinical studies. We evaluated the combination of gemcitabine, cisplatin and methylprednisolone (GEM-P) in 41 heavily pretreated patients with relapsed and refractory Hodgkin's and non-Hodgkin's lymphoma. The best-achieved response rate (RR) was 79% (95% CI 64 -91), with a complete RR of 21%. In patients with chemo-resistant disease, the RR was 63%. Myelosuppression was the main toxicity, the incidence of Grade 3 or 4 anaemia, neutropenia and thrombocytopenia was 17.1, 61.0 and 53.7% respectively. Only one patient had neutropenic sepsis and none of the patients suffered from haemorrhage. Grade 3 or 4 nonhaematological toxicity was minimal and stem cell mobilisation was not inhibited. GEM-P is an effective salvage regimen and its use prior to autologous stem cell transplant warrants further investigation.

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Section: Evaluation Of Responsementioning

confidence: 99%

Gemcitabine, cisplatin and methylprednisolone (GEM-P) is an effective salvage regimen in patients with relapsed and refractory lymphoma

Waters

Cunningham

et al. 2005

Br J Cancer

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“…No response (NR) was a decrease Ͻ 50% in measurable lesions; and, finally, progressive disease (PD) was an increase in the size of at least 1 measurable lesion, or the appearance of at least 1 new lesion, or the recurrence of symptoms. 6 One hundred two patients were included in the MH-1 trial. Three patients with misdiagnosed stage IIIA disease, two patients with mediastinal bulk, three patients with histologic types other than those requested, and one experienced patient were excluded due to protocol violations.…”

Section: Patient Populations and Staging Proceduresmentioning

confidence: 99%

Vinblastine, bleomycin, and methotrexate chemotherapy plus irradiation for patients with early‐stage, favorable Hodgkin lymphoma

Gobbi

Broglia

Merli

et al. 2003

Cancer

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BACKGROUNDThe acknowledged effectiveness of vinblastine, bleomycin, and methotrexate (VBM) chemotherapy in patients with early‐stage Hodgkin lymphoma has been associated with conflicting toxicity reports.METHODSOne hundred forty‐three patients were evaluated clinically and had favorable Stage IA or IIA Hodgkin lymphoma. Ninety‐three patients were treated with the standard VBM schedule combined with extended‐field radiotherapy (EF‐RT), leaving the choice of the therapeutic sequence free. Fifty subsequent patients were treated with a slightly modified VBM schedule (VbMp) combined with RT limited to involved fields (IF‐RT) and delivered only after the end of chemotherapy. In the VbMp schedule, intervals between cycles were 21 days instead of 28 days, bleomycin doses were reduced, small doses of prednisone were given orally, and the interval before RT was prolonged.RESULTSClinical response was complete in 96% of patients who were treated with VBM plus EF‐RT and in 94% of patients who were treated with VbMp plus IF‐RT. Recurrence rates were nearly identical (12% and 11%, respectively) over necessarily different follow‐up (91 months and 33 months, respectively). Hematologic toxicity was tolerable in both trials, and pulmonary side effects were moderate in the first trial and negligible in the second. On the whole, treatment was tolerated better when RT followed chemotherapy.CONCLUSIONSThe VBM regimen was confirmed to be effective in patients with early‐stage Hodgkin lymphoma. Administration of all cycles before RT improved tolerance; pulmonary toxicity probably is mitigated further by reduced bleomycin doses, mild prednisone therapy, and a more prolonged resting interval before RT. A slightly higher recurrence rate was expectable in the VBM plus IF‐RT trial despite the actual intensification of vinblastine and methotrexate. Cancer 2003. © 2003 American Cancer Society.

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“…21 A small proportion of patients patients with Hodgkin's disease, treated with high-dose received hybrid regimens such as MOPP/ABV (mustine, therapy and ASCT for first relapse after chemotherapy were vincristine, procarbazine, prednisone, doxorubicin, bleoreported to the EBMT from 31 centres. mycin, vinblastine), 22 or intensive weekly regimens such as Patients were included in this analysis if they had PACE/BOM (prednisone, doxorubicin, cyclophosphamide, achieved a complete remission (CR), or complete remission etoposide, bleomycin, vincristine, methotrexate) 23 or uncertain (CR u ) according to the Cotswolds response cri-VAPEC-B (vinblastine, doxorubicin, prednisone, etopoteria, 17 after initial combination chemotherapy.…”

Section: Group For Blood and Marrow Transplantation (Ebmt)mentioning

confidence: 99%

High-dose therapy and autologous stem cell rescue for patients with Hodgkin’s disease in first relapse after chemotherapy: results from the EBMT

Sweetenham

Taghipour

Milligan

et al. 1997

Bone Marrow Transplant

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Summary:The use of conventional-dose salvage chemotherapy in The purpose of this study was to investigate the results patients with Hodgkin's disease who relapse after initial of high-dose therapy and autologous stem cell transcombination chemotherapy is associated with high plantation in adult patients with Hodgkin's disease in remission rates, especially if the initial CR duration is first relapse after chemotherapy, to determine the overlonger than 1 year. 1-5 However, long-term follow-up studall and progression-free survival, identify prognostic ies have shown that less than 20% of these patients achieve factors for outcome, and to define the role of conventional dose salvage therapy given prior to the high dose long-term disease-free survival. 6 regimen. A retrospective analysis of 139 adult patients High-dose therapy, with autologous stem cell transplanreported to the lymphoma registry of the European tation (ASCT), has been used extensively in patients with Group for Blood and Marrow Transplantation (EBMT)relapsed Hodgkin's disease. [7][8][9][10][11][12][13][14] In early studies, its use was between February 1984 and July 1995 is considered.confined to patients who had failed multiple combination Data on all patients were reviewed and prognostic facchemotherapy regimens. Analysis of prognostic factors in tors determined in univariate analysis. The actuarial 5-these studies demonstrated that extensive prior therapy, year overall survival (OS) and progression-free survival short remission duration, resistance of disease to conven-(PFS) for the entire group of 139 patients were 49.4 and tional-dose chemotherapy and bulk disease at the time of 44.7%, respectively. In univariate analysis for OS, dis-ASCT were commonly identified adverse features. ease bulk at the time of high-dose therapy, second-line As a result of these findings, and of decision analyses regimen, initial remission duration and status at transregarding the use of high-dose therapy, 15 several groups plant had no predictive value. Status at transplant was have recently reported the use of high-dose therapy in predictive for OS when patients in second complete patients with Hodgkin's disease at the time of the first remission (CR) were analysed separately from those in relapse after chemotherapy. 10,13,14,16 These single institution chemosensitive relapse. Similar trends were observed studies have shown a favourable outcome for these patients for PFS. We concluded that high-dose therapy and autocompared with historical series of conventionally treated logous stem cell transplantation is an effective strategy patients, and have again identified prognostic factors for for patients with Hodgkin's disease in first relapse after long-term disease-free survival, including duration of initial chemotherapy. These results suggest that it should be remission, disease bulk at the time of ASCT, and sensitivity used regardless of initial remission duration. The role to conventional-dose therapy given prior to the high-dose of conventional-dose salvage give...

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Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting.

Cited by 1,463 publications

References 13 publications

Gemcitabine, cisplatin and methylprednisolone (GEM-P) is an effective salvage regimen in patients with relapsed and refractory lymphoma

Gemcitabine, cisplatin and methylprednisolone (GEM-P) is an effective salvage regimen in patients with relapsed and refractory lymphoma

Vinblastine, bleomycin, and methotrexate chemotherapy plus irradiation for patients with early‐stage, favorable Hodgkin lymphoma

High-dose therapy and autologous stem cell rescue for patients with Hodgkin’s disease in first relapse after chemotherapy: results from the EBMT

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