Successful marrow transplantation for acute myelocytic leukemia following therapy for Hodgkin's disease.

1988 ◽  
Vol 6 (10) ◽  
pp. 1558-1561 ◽  
Author(s):  
R B Geller ◽  
G B Vogelsang ◽  
J R Wingard ◽  
A M Yeager ◽  
W H Burns ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Marrow Transplantation ◽  
Hematologic Malignancy ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Intensive Therapy ◽  
Acute Myelocytic Leukemia ◽  
Myelocytic Leukemia ◽  
Histocompatibility Locus

Five patients with acute myelocytic leukemia (AML) after combined modality therapy for Hodgkin's disease (HD) were treated with cyclophosphamide and busulfan followed by bone marrow transplantation (BMT). Four patients received allogeneic transplants from histocompatibility locus antigen (HLA)-compatible siblings and the fifth patient received an autologous marrow treated with 4-hydroperoxycyclophosphamide. Two patients died of complications of acute graft-v-host disease (GVHD) despite prophylaxis with either low-dose cyclophosphamide or cyclosporine. The remaining three patients were alive and disease-free 382, 617, and 620 days after transplant. These initial results are encouraging and more patients with treatment-related AML need to be evaluated with both allogeneic and autologous BMT to fully elucidate the potentially curative role of this intensive therapy in an otherwise fatal hematologic malignancy.

The role of staging laparotomy in combined modality therapy of Hodgkin's disease: A new treatment plan based on a 6-year experience

1978 ◽  
Vol 2 (1) ◽  
pp. 101-105 ◽  
Author(s):  
Richard E. Wilson ◽  
Robert T. Osteen ◽  
David S. Rosenthal ◽  
Peter M. Mauch ◽  
Robert L. Goodman
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Treatment Plan ◽  
Combined Modality Therapy ◽  
Staging Laparotomy ◽  
Combined Modality ◽  
New Treatment

Mini-BEAM as salvage therapy for relapsed or refractory Hodgkin's disease before intensive therapy and autologous bone marrow transplantation.

1995 ◽  
Vol 13 (2) ◽  
pp. 396-402 ◽  
Author(s):  
R Colwill ◽  
M Crump ◽  
F Couture ◽  
R Danish ◽  
A K Stewart ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Salvage Therapy ◽  
Hodgkin's Disease ◽  
Marrow Transplantation ◽  
Hodgkin’S Disease ◽  
Intensive Therapy ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
Autologous Bone

PURPOSE To evaluate the efficacy of carmustine (BCNU), etoposide, cytarabine (Ara-C), and melphalan (mini-BEAM) as salvage therapy in patients with relapsed or refractory Hodgkin's disease who were potentially eligible to undergo intensive therapy and autologous bone marrow transplantation (ABMT). PATIENTS AND METHODS Forty-four patients with refractory or relapsed Hodgkin's disease after front-line combination chemotherapy referred for consideration of ABMT were treated with mini-BEAM (BCNU 60 mg/m2 on day 1, etoposide 75 mg/m2 on days 2 to 5, Ara-C 100 mg/m2 twice per day on days 2 to 5, and melphalan 30 mg/m2 on day 6) to maximum response. Eleven patients were refractory to primary chemotherapy. Twenty-three patients were treated in first relapse and 10 in second or subsequent relapse; 21 received mini-BEAM as their first salvage regimen. Patients were restaged to determine disease status immediately before intensive therapy and transplant. RESULTS The overall response rate was 84% (exact 95% confidence interval [CI], 70% to 92%), with a complete response (CR) rate of 32% (95% CI, 20% to 47%) and a partial response (PR) rate of 52%. No treatment-related deaths were observed. Myelosuppression was the major toxicity. Almost all patients required platelet transfusions. Eighty-four percent were given RBC transfusions, and 54% required intravenous antibiotics for fever while neutropenic. CONCLUSION Mini-BEAM is a safe and effective regimen for treatment of refractory or relapsed Hodgkin's disease. Further studies are required to determine if responding patients have improved disease-free survival (DFS) after intensive therapy and ABMT.

Splenectomy and the increasing risk of secondary acute leukemia in Hodgkin's disease.

1993 ◽  
Vol 11 (5) ◽  
pp. 925-930 ◽  
Author(s):  
S Tura ◽  
M Fiacchini ◽  
P L Zinzani ◽  
E Brusamolino ◽  
P G Gobbi
Keyword(s):  
Hodgkin's Disease ◽  
Proportional Hazards ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Secondary Leukemia ◽  
Proportional Hazards Regression ◽  
Combined Modality ◽  
Leukemia Development ◽  
Increasing Risk

PURPOSE Following irradiation alone, secondary acute nonlymphocytic leukemia (ANLL) is uncommon; following chemotherapy alone, the risk is increased, but not as much as when combined modality treatments are used. Because ANLL seems more likely to occur in splenectomized patients, attention is focused on an unexpected association between splenectomy and the risk of secondary leukemia. PATIENTS AND METHODS The risk of ANLL was assessed in 503 patients with Hodgkin's disease (HD) homogeneously treated with combined modality therapy (mechlorethamine, vincristine, procarbazine, and prednisone [MOPP] plus radiotherapy). These patients were diagnosed from 1970 through 1984 and monitored until June 1991. RESULTS ANLL was observed in one of 145 (0.69%) patients not splenectomized and in 21 of 358 (5.86%) splenectomized patients, demonstrating a significantly higher frequency of ANLL in the group of patients who underwent splenectomy. The group of patients who developed ANLL received a statistically greater number of MOPP courses than did the group not developing ANLL. ANLL was statistically more frequent in those patients who received more than four cycles of MOPP. Sex, symptoms, extent of radiotherapy, splenectomy, age, and number of MOPP courses were assessed for their impact on ANLL incidence by multivariate analysis. CONCLUSION Cox's proportional hazards regression showed that splenectomy and, as previously described by others, the number of courses of MOPP are prognostic factors that increase the risk of secondary ANLL in HD patients treated with combined modality therapy. These data raise interesting questions regarding the possible role of the spleen in leukemia development.

The role of combined modality therapy in symptomatic Hodgkin's disease, stage IB–IIIB

1980 ◽  
Vol 6 (10) ◽  
pp. 1364-1365
Author(s):  
Peter Mauch ◽  
MaryEllen Ryback ◽  
Alan Lewin ◽  
David Rosenthal ◽  
Samuel Hellman
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Disease Stage ◽  
Stage Ib ◽  
Combined Modality
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