Allogeneic marrow transplantation in the treatment of MOPP-resistant Hodgkin's disease.

1985 ◽  
Vol 3 (11) ◽  
pp. 1490-1494 ◽  
Author(s):  
F R Appelbaum ◽  
K M Sullivan ◽  
E D Thomas ◽  
C D Buckner ◽  
R A Clift ◽  
...  
Keyword(s):  
Complete Remission ◽  
Hodgkin's Disease ◽  
Marrow Transplantation ◽  
Hodgkin’S Disease ◽  
The Other ◽  
High Dose ◽  
Allogeneic Marrow Transplantation ◽  
Allogeneic Marrow ◽  
Transplant Procedure ◽  
Severe Mucositis

Eight patients with disseminated Hodgkin's disease resistant to MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) chemotherapy were treated with high-dose chemoradiotherapy and marrow transplantation from an HLA-identical sibling. Two patients remain alive in unmaintained complete remission (CR) at 38 and 39 months after transplant. In the other six patients, reasons for failure included relapse of lymphoma (two patients), or death due to complications of the transplant procedure, including Legionnaire's disease, disseminated zoster, graft-v-host disease, and aspiration pneumonia secondary to severe mucositis. These results demonstrate that some patients with MOPP-resistant Hodgkin's disease can obtain prolonged CR following intensive chemoradiotherapy and allogeneic marrow transplantation.

Allogeneic marrow transplantation for refractory Hodgkin's disease.

1989 ◽  
Vol 7 (8) ◽  
pp. 1039-1045 ◽  
Author(s):  
G L Phillips ◽  
D E Reece ◽  
M J Barnett ◽  
J M Connors ◽  
J W Fay ◽  
...  
Keyword(s):  
Patient Selection ◽  
Hodgkin's Disease ◽  
Marrow Transplantation ◽  
Lymphoproliferative Disorder ◽  
Hodgkin’S Disease ◽  
Substantial Toxicity ◽  
Allogeneic Marrow Transplantation ◽  
Allogeneic Marrow ◽  
Advanced Hodgkin’S Disease

Eight patients with refractory Hodgkin's disease received intensive combination chemotherapy conditioning with cyclophosphamide, carmustine (BCNU), and etoposide (VP 16-213), and allogeneic marrow transplants. All patients achieved complete responses. Three patients relapsed; two died of Hodgkin's disease and one of chronic graft-v-host disease (GVHD) and infection. In all, four patients died due to transplant-related toxicity. One patient developed a fatal B-cell lymphoproliferative disorder soon after transplantation, and died without evidence of Hodgkin's disease. One patient is alive and free of progression 29 months after transplantation. These data indicate that allogeneic marrow transplantation may be considered as therapy for selected patients with advanced Hodgkin's disease and, despite substantial toxicity, will occasionally result in long-term responses. Better patient selection would likely improve results.

Outcome of patients with Hodgkin's disease failing after primary MOPP-ABVD.

1997 ◽  
Vol 15 (2) ◽  
pp. 528-534 ◽  
Author(s):  
V Bonfante ◽  
A Santoro ◽  
S Viviani ◽  
L Devizzi ◽  
M Balzarotti ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Complete Remission ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Response Duration ◽  
Long Term Results ◽  
High Dose ◽  
First Line ◽  
Disease Extent

PURPOSE This study analyzed long-term results in patients with Hodgkin's disease who were resistant to or relapsed after first-line treatment with MOPP and ABVD. Response to salvage treatments and prognostic factors were also evaluated. PATIENTS AND METHODS The study population included 115 refractory or relapsed patients among a total of 415 patients treated with alternating or hybrid MOPP-ABVD followed by radiotherapy (25 to 30 Gy) to initial bulky sites. The median follow-up duration of the present series was 91 months. Thirty-nine of 115 patients (34%) showed disease progression while on primary treatment (induction failures); 48 relapsed after complete remissions that lasted < or = 12 months and 28 after complete remission that lasted more than 12 months from the end of all treatments. RESULTS At 8 years, the overall survival rate was 27%, being 54% and 28% in patients whose initial complete remission was longer or shorter than 12 months, respectively, and 8% in induction failures (P < .001). Response to first-line chemotherapy and disease extent at first progression significantly influenced long-term results, as well as the incidence and duration of complete remission. CONCLUSION The present data confirm previous observations that showed the main prognostic factors to influence outcome after salvage treatment are response duration to first-line therapy and disease extent at relapse. The results indicate that patients who relapse after the alternating MOPP/ABVD regimen have a prognosis similar to that of patients who relapse after a four-drug regimen (MOPP or ABVD alone). Re-treatment with initial chemotherapy seems the treatment of choice for patients who relapse after an initial complete remission that lasts greater than 12 months, while the real impact of high-dose chemotherapy or new regimens should be assessed in resistant patients.

Successful treatment with minimal chemotherapy followed by low-dose involved field radiotherapy in children with Hodgkin's disease: A 20-year experience in a single institution in Greece

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10052-10052
Author(s):  
A. G. Pourtsidis ◽  
D. Doganis ◽  
M. Baka ◽  
D. Bouhoutsou ◽  
M. Varvoutsi ◽  
...  
Keyword(s):  
Complete Remission ◽  
Hodgkin's Disease ◽  
Low Dose ◽  
Early Stage ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Stage Iv ◽  
High Dose ◽  
Main Question ◽  
Radio Therapy

10052 Background: The vast majority of children with Hodgkin's disease (HD) nowadays have an excellent chance of definite cure. The high curative rates as well as the prevention of late effects have to be among aims when managing children with HD. The purpose of our retrospective study was to report the outcome and prognostic factors of patients (pts) less than 15 years of age with HD treated with chemotherapy (CT) followed by low dose radiation from 1987 to 2006. Methods: We studied 58 children analyzing the following data: age, sex, stage, histology, therapy correlating these with the outcome of pts. Among 35 boys and 23 girls, age at diagnosis 4.5 - 15 years (median 12), all aged 7 years or less were boys (8/58). Nodurar sclerosis was the predominant histology subtype (69%) and 45% had advanced disease (stages III or IV). According the study period pts with early stage received 4 cycles of ABVD or VBVP and those with advanced stage disease alternating 3 cycles of MOPP/ABVD or 2 of MOPP/ABVP for stage III and alternating 3 cycles of MOPP/ABVD or 2 OPPA plus 4 COPP for stage IV. All pts had a good response (more than a 70% reduction) after initial CT and received 20 Gy of RT to initially involved fields. Results: Complete remission (CR) was achieved in all patients. Chemo- and radio-therapy were well tolerated. Fifty-three pts (DFS: 91.4%) live in their first complete remission. In 5 pts (8.6 %) relapse occurred, 20 -65 months from dx (median 25 mo). All received salvage treatment in combination with high dose CT and autologous stem-cell transplantation (SCT). Of the 5 relapsed all live 21 - 207 months (median 75 mo) from the dx of relapse and 41 - 232 mo (median 99) from the dx of disease. Second (thyroid cancer) plus third malignancy in one (osteosarcoma) was detected in 3 pts and all are alive. Finally for our group the overall survival is 100% and all children are alive 25 - 264 mo from dx (median 145 mo) and the event free survival is 86.2% (50/58). No factors related to the outcome were detected. Conclusions: In conclusion combined-modality therapy remains the standard of care for children with HD. However, there may be a significant number who can be cured with chemotherapy alone. At this moment the main question is: who can be cured without RT? No significant financial relationships to disclose.

Prognostic factors for response and survival after high-dose cyclophosphamide, carmustine, and etoposide with autologous bone marrow transplantation for relapsed Hodgkin's disease.

1989 ◽  
Vol 7 (2) ◽  
pp. 179-185 ◽  
Author(s):  
S Jagannath ◽  
J O Armitage ◽  
K A Dicke ◽  
S L Tucker ◽  
W S Velasquez ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Hodgkin's Disease ◽  
Marrow Transplantation ◽  
Hodgkin’S Disease ◽  
Autologous Bone Marrow Transplantation ◽  
Significant Proportion ◽  
Autologous Bone Marrow ◽  
High Dose ◽  
Autologous Bone

Sixty-one patients with relapsed Hodgkin's disease who had failed a mechlorethamine, vincristine, procarbazine, and prednisone (MOPP)- and a doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD)-like regimen were treated with a high-dose combination chemotherapy containing cyclophosphamide, carmustine, and etoposide (CBV) and autologous bone marrow transplantation (ABMT). Fifty-nine patients were treated in relapse and two were intensified early in third remission. Following therapy, 29 patients (47%) were in complete remission (CR), 18 patients (30%) achieved a partial response (PR), and 14 patients (23%) had progressive disease (PD). Among the partial responders, six patients achieved a CR following addition of local radiation therapy to sites of residual nodal disease. For a minimum follow-up of 2 years, 23 patients (38%) are alive and free of disease. High-dose CBV therapy produced severe myelosuppression, and there were four (7%) treatment-related deaths. A multivariate analysis identified failure of more than two prior chemotherapy treatments and poor performance status as important adverse risk factors for survival. Patients who had no adverse risk factor and/or were intensified with CBV while Hodgkin's disease was still responding to conventional chemotherapy, had a CR rate of 63%, with 77% projected 3-year survival; whereas, all other patients had a CR rate of 31%, and a projected 3-year survival of only 18%. Our results demonstrated that CBV and ABMT can induce remission duration of 2 years or greater in a significant proportion of patients with relapsed Hodgkin's disease.

scholarly journals Successful treatment of refractory Hodgkin's disease by high-dose combination chemotherapy and autologous bone marrow transplantation

Blood ◽  
1989 ◽  
Vol 73 (1) ◽  
pp. 340-344 ◽  
Author(s):  
JG Gribben ◽  
DC Linch ◽  
CR Singer ◽  
AK McMillan ◽  
M Jarrett ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Complete Remission ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
High Dose ◽  
Dose Combination ◽  
Autologous Bone

Abstract Forty-four patients with refractory Hodgkin's disease were treated with high-dose combination chemotherapy followed by autologous bone marrow rescue. Twenty-two patients (50%) entered complete remission within 6 months of the procedure and four other patients are free of disease progression. Only two patients have subsequently relapsed from complete remission (CR). Bone marrow suppression was the predictable major toxicity of this procedure, and two patients (4.5%) died of sepsis during the aplastic phase. High-dose therapy with autologous bone marrow transplantation (ABMT) appears to be an effective salvage regimen for patients with refractory Hodgkin's disease.

Allogeneic, syngeneic, and autologous marrow transplantation for Hodgkin's disease: the 21-year Seattle experience.

1993 ◽  
Vol 11 (12) ◽  
pp. 2342-2350 ◽  
Author(s):  
J E Anderson ◽  
M R Litzow ◽  
F R Appelbaum ◽  
G Schoch ◽  
L D Fisher ◽  
...  
Keyword(s):  
Relapse Rate ◽  
Hodgkin's Disease ◽  
Marrow Transplantation ◽  
Hodgkin’S Disease ◽  
Performance Status ◽  
Univariate Analysis ◽  
Mortality Rates ◽  
Bulky Disease ◽  
First Relapse ◽  
Allogeneic Marrow

PURPOSE To analyze results of 127 patients undergoing myeloablative therapy followed by marrow transplantation for relapsed or refractory Hodgkin's disease. PATIENTS AND METHODS Twenty-three patients had primary refractory disease, 34 were in early first relapse or second complete remission (CR), and 70 had refractory first relapse or disease beyond second CR. Preparative regimens included total-body irradiation (TBI) and chemotherapy (n = 61) or chemotherapy only (n = 66). Sixty-eight patients received autologous marrow, six syngeneic marrow, and 53 allogeneic marrow. RESULTS The 5-year actuarial probabilities of survival, event-free survival (EFS), relapse, and nonrelapse mortality for the entire group were 21%, 18%, 65%, and 49%, respectively. HLA-identical allogeneic marrow recipients had a statistically lower relapse rate compared with recipients of autologous marrow, but survival, EFS, and nonrelapse mortality rates were not significantly different. In the multivariate analysis, higher performance status and absence of bulky disease predicted for improved EFS and lower relapse rates, while fewer prior treatment regimens predicted for improved EFS and lower nonrelapse mortality rates. Additionally, the univariate analysis showed that patients who underwent transplantation with disease refractory to chemotherapy or beyond second CR had a worse outcome compared with those who had less advanced disease. CONCLUSION Outcome with transplantation for patients with Hodgkin's disease is improved if transplantation is performed early after relapse when disease burden is less, tumor chemosensitivity is greater, and the patient is likely to have a better performance status. The use of HLA-matched sibling marrow results in a lower relapse rate and, thus, for some individuals, may be preferable to the use of autologous marrow.

Increased risk of leukemia relapse with high dose cyclosporine after allogeneic marrow transplantation for acute leukemia: 10 year follow-up of a randomized study

Blood ◽  
2001 ◽  
Vol 98 (10) ◽  
pp. 3174-3174 ◽  
Author(s):  
Andrea Bacigalupo ◽  
Teresa Lamparelli ◽  
Francesca Gualandi ◽  
Stefania Bregante ◽  
AnnaMaria Raiola ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Marrow Transplantation ◽  
Randomized Study ◽  
High Dose ◽  
Increased Risk ◽  
Leukemia Relapse ◽  
Allogeneic Marrow Transplantation ◽  
Allogeneic Marrow
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