| pubmed-article:10534059 | rdf:type | pubmed:Citation | lld:pubmed |
| pubmed-article:10534059 | lifeskim:mentions | umls-concept:C1522449 | lld:lifeskim |
| pubmed-article:10534059 | lifeskim:mentions | umls-concept:C0005953 | lld:lifeskim |
| pubmed-article:10534059 | lifeskim:mentions | umls-concept:C0019829 | lld:lifeskim |
| pubmed-article:10534059 | lifeskim:mentions | umls-concept:C1504389 | lld:lifeskim |
| pubmed-article:10534059 | lifeskim:mentions | umls-concept:C0392920 | lld:lifeskim |
| pubmed-article:10534059 | lifeskim:mentions | umls-concept:C0677874 | lld:lifeskim |
| pubmed-article:10534059 | lifeskim:mentions | umls-concept:C0439859 | lld:lifeskim |
| pubmed-article:10534059 | lifeskim:mentions | umls-concept:C0728938 | lld:lifeskim |
| pubmed-article:10534059 | pubmed:issue | 5 | lld:pubmed |
| pubmed-article:10534059 | pubmed:dateCreated | 1999-11-24 | lld:pubmed |
| pubmed-article:10534059 | pubmed:abstractText | Complete remission rates of 70-90% can be achieved following combination chemotherapy for patients with advanced-stage Hodgkin's disease (HD). Patients who present with unfavorable poor prognostic factors, however, have a 5-year disease-free survival of only 40-50%. In an attempt to improve the prognosis of 20 patients with poor-risk advanced-stage HD, we evaluated the role of early high-dose therapy (HDT) and autologous bone marrow/stem cell transplantation (ASCT) during the first complete or partial remission (CR/PR). Patients were eligible for ASCT if they either achieved a PR (defined as > 50% regression) (six patients), or achieved a CR (14 patients) but had presented with three or more of the following unfavorable features: stage IV disease with bone marrow involvement or > or = 2 extranodal sites of involvement; bulky mass > 10 cm or bulky mediastinal mass > 1/3 of mediastina/thoracic ratio; B symptoms; and elevated serum lactate dehydrogenase (LDH) level. The study included 11 men (55%) and 9 women (45%). The median age was 37 years (range 20-57). Seventeen patients (85%) had stage IV disease; 14 (70%) had B symptoms; 13 (65%) had bulky mass > 10 cm; 14 (70%) had > or = 2 extra nodal sites involvement; and eight patients (40%) had elevated LDH levels. All patients were treated with standard four or 7-8 drug combination chemotherapy regimens until they achieved maximal response prior to ASCT with a median of six cycles (range 4-11). Six patients also received involved field radiotherapy to residual bulky mass > 5 cm or bony lesions before ASCT. The median time from diagnosis to ASCT was 8.6 months (range 5.5-18.9). Preparative regimens consisted of fractionated total body irradiation (FTBI) 1200 cGy in combination with etoposide 60 mg/kg and cyclophosphamide 100 mg/kg in all patients except one who had borderline pulmonary function and received lomustine 15 mg/kg instead of FTBI. All patients engrafted and there was no transplant-related mortality. One patient developed congestive cardiomyopathy at 4 years post-ASCT. All patients remain alive and in remission at a median follow-up of 42.8 months (range, 13.2-149.2). These preliminary results suggest that HDT and ASCT can be performed safely during first CR/PR in selected patients with advanced-stage HD who have an unfavorable prognosis. Further randomized studies comparing HDT and ASCT during first CR with conventional chemotherapy and ASCT at relapse in poor-risk advanced-stage HD should be conducted. The prognostic factors and risk groups described recently by an international prognostic study can be used to identify high-risk patients who may be candidates for more intensive therapy. | lld:pubmed |
| pubmed-article:10534059 | pubmed:grant | http://linkedlifedata.com/r... | lld:pubmed |
| pubmed-article:10534059 | pubmed:grant | http://linkedlifedata.com/r... | lld:pubmed |
| pubmed-article:10534059 | pubmed:language | eng | lld:pubmed |
| pubmed-article:10534059 | pubmed:journal | http://linkedlifedata.com/r... | lld:pubmed |
| pubmed-article:10534059 | pubmed:citationSubset | IM | lld:pubmed |
| pubmed-article:10534059 | pubmed:status | MEDLINE | lld:pubmed |
| pubmed-article:10534059 | pubmed:issn | 1083-8791 | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:SnyderD SDS | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:MolinaAA | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:SteinAA | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:BhatiaRR | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:ParkerPP | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:VoraNN | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:FormanS JSJ | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:FungHH | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:SniecinskiII | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:NilandJ CJC | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:KashyapAA | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:O'DonnellM... | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:NademaneeAA | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:KrishnanAA | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:SpielbergerRR | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:PlanasII | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:DagisAA | lld:pubmed |
| pubmed-article:10534059 | pubmed:author | pubmed-author:SlovakMM | lld:pubmed |
| pubmed-article:10534059 | pubmed:issnType | Print | lld:pubmed |
| pubmed-article:10534059 | pubmed:volume | 5 | lld:pubmed |
| pubmed-article:10534059 | pubmed:owner | NLM | lld:pubmed |
| pubmed-article:10534059 | pubmed:authorsComplete | Y | lld:pubmed |
| pubmed-article:10534059 | pubmed:pagination | 292-8 | lld:pubmed |
| pubmed-article:10534059 | pubmed:dateRevised | 2007-11-14 | lld:pubmed |
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| pubmed-article:10534059 | pubmed:meshHeading | pubmed-meshheading:10534059... | lld:pubmed |
| pubmed-article:10534059 | pubmed:meshHeading | pubmed-meshheading:10534059... | lld:pubmed |
| pubmed-article:10534059 | pubmed:meshHeading | pubmed-meshheading:10534059... | lld:pubmed |
| pubmed-article:10534059 | pubmed:meshHeading | pubmed-meshheading:10534059... | lld:pubmed |
| pubmed-article:10534059 | pubmed:meshHeading | pubmed-meshheading:10534059... | lld:pubmed |
| pubmed-article:10534059 | pubmed:meshHeading | pubmed-meshheading:10534059... | lld:pubmed |
| pubmed-article:10534059 | pubmed:year | 1999 | lld:pubmed |
| pubmed-article:10534059 | pubmed:articleTitle | High-dose chemo/radiotherapy and autologous bone marrow or stem cell transplantation for poor-risk advanced-stage Hodgkin's disease during first partial or complete remission. | lld:pubmed |
| pubmed-article:10534059 | pubmed:affiliation | Department of Hematology and Bone Marrow Transplantation, City of Hope National Medical Center, Duarte, California 91010, USA. | lld:pubmed |
| pubmed-article:10534059 | pubmed:publicationType | Journal Article | lld:pubmed |
| pubmed-article:10534059 | pubmed:publicationType | Clinical Trial | lld:pubmed |
| pubmed-article:10534059 | pubmed:publicationType | Research Support, U.S. Gov't, P.H.S. | lld:pubmed |
| http://linkedlifedata.com/r... | pubmed:referesTo | pubmed-article:10534059 | lld:pubmed |
