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.

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.

Randomized Comparison of ABVD and MOPP/ABV Hybrid for the Treatment of Advanced Hodgkin’s Disease: Report of an Intergroup Trial

2003 ◽  
Vol 21 (4) ◽  
pp. 607-614 ◽  
Author(s):  
David B. Duggan ◽  
Gina R. Petroni ◽  
Jeffrey L. Johnson ◽  
John H. Glick ◽  
Richard I. Fisher ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Hematologic Toxicity ◽  
Standard Regimen ◽  
Life Threatening ◽  
P 16 ◽  
Clinically Significant ◽  
Advanced Hodgkin’S Disease

Purpose: In a series of trials, doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine (MOPP/ABV) have been identified as effective treatments for Hodgkin’s disease. We compared these regimens as initial chemotherapy for Hodgkin’s disease. Patients and Methods: Adult patients (N = 856) with advanced Hodgkin’s disease were randomly assigned to treatment with ABVD or MOPP/ABV. The major end points were failure-free and overall survival, life-threatening acute toxicities, and serious long-term toxicities, including cardiomyopathy, pulmonary toxicity, myelodysplastic syndromes (MDS), and secondary malignancies. Results: The rates of complete remission (76% v 80%, P = .16), failure-free survival at 5 years (63% v 66%, P = .42), and overall survival at 5 years (82% v 81%, P = .82) were similar for ABVD and MOPP/ABV, respectively. Clinically significant acute pulmonary and hematologic toxicity were more common with MOPP/ABV (P = .060 and .001, respectively). There was no difference in cardiac toxicity. There were 24 deaths attributed to initial treatment: nine with ABVD and 15 with MOPP/ABV (P = .057). There have been 18 second malignancies associated with ABVD and 28 associated with MOPP/ABV (P = .13). Thirteen patients have developed MDS or acute leukemia: 11 were initially treated with MOPP/ABV, and two were initially treated with ABVD but subsequently received MOPP-containing regimens and radiotherapy before developing leukemia (P = .011). Conclusion: ABVD and the MOPP/ABV hybrid are effective therapies for Hodgkin’s disease. MOPP/ABV is associated with a greater incidence of acute toxicity, MDS, and leukemia. ABVD should be considered the standard regimen for treatment of advanced Hodgkin’s disease.

scholarly journals Long term remissions with combined modality therapy for advanced Hodgkin's disease

Cancer ◽  
1976 ◽  
Vol 37 (6) ◽  
pp. 2826-2833 ◽  
Author(s):  
Leonard R. Prosnitz ◽  
Leonard R. Farber ◽  
James J. Fischer ◽  
Joseph R. Bertino ◽  
Diana B. Fischer
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Combined Modality ◽  
Advanced 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.

scholarly journals Long-term pulmonary function abnormalities and survival after allogeneic marrow transplantation

2004 ◽  
Vol 33 (5) ◽  
pp. 509-517 ◽  
Author(s):  
T K Marras ◽  
C K Chan ◽  
J H Lipton ◽  
H A Messner ◽  
J P Szalai ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Marrow Transplantation ◽  
Allogeneic Marrow Transplantation ◽  
Allogeneic Marrow
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