Effectiveness of high dose chemoradiotherapy and autologous stem cell transplantation for patients with biopsy-proven primary refractory Hodgkin's disease Journal Article

  

Authors:	Moskowitz, C. H.; Kewalramani, T.; Nimer, S. D.; Gonzalez, M.; Zelenetz, A. D.; Yahalom, J.
Article Title:	Effectiveness of high dose chemoradiotherapy and autologous stem cell transplantation for patients with biopsy-proven primary refractory Hodgkin's disease
Abstract:	Prospective randomized studies have determined that high dose therapy and autologous stem cell transplantation (ASCT) is the standard treatment for patients with chemosensitive relapsed Hodgkin's disease (HD); however, the role of this approach in patients with primary refractory disease has been controversial. This report is an integrated analysis of 75 consecutive patients with biopsy-confirmed primary refractory HD, who were treated with high dose chemoradiotherapy (HDT) and ASCT at the Memorial Sloan Kettering Cancer Center. The patients underwent conventional dose cytoreductive chemotherapy followed by HDT and ASCT. At a median follow-up of 10 years for surviving patients, the event-free survival (EFS), progression-free survival (PFS) and overall survival (OS) rates were 45%, 49% and 48% respectively. Only chemosensitivity to standard-dose second-line chemotherapy (SDSC) predicted for a better survival, thus responding patients had an EFS, PFS and OS of 60%, 62% and 66%, respectively, versus 19%, 23% and 17% for patients who had a poor response to SDSC (P < 0.001). While patients with chemosensitive disease have an excellent outcome with HDT and ASCT, novel approaches are needed to cure HD patients who fail front-line and second-line chemotherapy. © 2004 Blackwell Publishing Ltd.
Keywords:	adolescent; adult; cancer survival; child; controlled study; school child; treatment outcome; disease-free survival; middle aged; survival rate; major clinical study; prednisone; doxorubicin; cancer combination chemotherapy; multimodality cancer therapy; cancer radiotherapy; radiation dose; combined modality therapy; methotrexate; drug megadose; follow up; follow-up studies; dacarbazine; etoposide; antineoplastic combined chemotherapy protocols; cyclophosphamide; vincristine; tumor biopsy; hematopoietic stem cell transplantation; drug resistance, neoplasm; chemosensitivity; carmustine; procarbazine; hodgkin disease; cancer center; bleomycin; transplantation, autologous; autologous hematopoietic stem cell transplantation; refractory; hodgkin's disease; humans; human; male; female; priority journal; article; asct; biopsy-proven; chemosensitive
Journal Title:	British Journal of Haematology
Volume:	124
Issue:	5
ISSN:	0007-1048
Publisher:	John Wiley & Sons
Date Published:	2004-03-01
Start Page:	645
End Page:	652
Language:	English
DOI:	10.1111/j.1365-2141.2003.04828.x
PROVIDER:	scopus
PUBMED:	14871252
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-1542359509&partnerID=40&md5=e16d6c66fdf98ca65a7699869dabd107
Notes:	Br. J. Haematol. -- Cited By (since 1996):94 -- Export Date: 16 June 2014 -- CODEN: BJHEA -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/53388