Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2001-4-23
pubmed:abstractText
Although patients with relapsed Hodgkin's disease have a poor prognosis with conventional therapies, high-dose chemotherapy and autologous hematopoietic stem cell transplantation (autotransplantation) may provide long-term progression-free survival. We reviewed data from the Autologous Blood and Marrow Transplant Registry (ABMTR) to determine relapse, disease-free survival, overall survival, and prognostic factors in this group of patients. Detailed records from the ABMTR on 414 patients with Hodgkin's disease in first relapse (n = 295) or second complete remission (CR) (n = 119) receiving an autotransplant from 1989 to 1995 were reviewed. Median age was 29 (range, 7-64) years. Median time from diagnosis to relapse was 18 (range, 6-219) months; median time from relapse to transplant was 5 (range, <1-215) months. Most patients received high-dose chemotherapy without total body irradiation for conditioning (n = 370). The most frequently used high-dose regimen was cyclophosphamide, BCNU, VP-16 (CBV) (n = 240). The graft consisted of bone marrow (n = 246), blood stem cells (n = 112), or both (n = 56). Median follow-up was 46 (range, 5-96) months. One hundred-day mortality (95% confidence interval) was 7 (5-9)%. One hundred and sixty-five of 295 patients (56%) transplanted in relapse achieved CR after autotransplantation. Of these, 61 (37%) recurred. Twenty-four of 119 patients (20%) transplanted in CR recurred. The probability of disease-free survival at 3 years was 46 (40-52)% for transplants in first relapse and 64 (53-72)% for those in second remission (P < 0.001). Overall survival at 3 years was 58 (52-64)% after transplantation in first relapse and 75 (66-83)% after transplantation in second CR (P < 0.001). In multivariate analysis, Karnofsky performance score <90% at transplant, abnormal serum LDH at transplant, and chemotherapy resistance were adverse prognostic factors for outcome. Progression of Hodgkin's disease accounted for 69% of all deaths. Autotransplantation should be considered for patients with Hodgkin's disease in first relapse or second remission. Future investigations should focus on strategies designed to decrease relapse after autotransplantation, particularly in patients at high risk for relapse.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
0268-3369
pubmed:author
pubmed:issnType
Print
pubmed:volume
27
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
387-96
pubmed:dateRevised
2007-11-14
pubmed:meshHeading
pubmed-meshheading:11313668-Adolescent, pubmed-meshheading:11313668-Adult, pubmed-meshheading:11313668-Cause of Death, pubmed-meshheading:11313668-Child, pubmed-meshheading:11313668-Disease-Free Survival, pubmed-meshheading:11313668-Female, pubmed-meshheading:11313668-Follow-Up Studies, pubmed-meshheading:11313668-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:11313668-Hodgkin Disease, pubmed-meshheading:11313668-Humans, pubmed-meshheading:11313668-Male, pubmed-meshheading:11313668-Middle Aged, pubmed-meshheading:11313668-Multivariate Analysis, pubmed-meshheading:11313668-Prognosis, pubmed-meshheading:11313668-Recurrence, pubmed-meshheading:11313668-Registries, pubmed-meshheading:11313668-Remission Induction, pubmed-meshheading:11313668-Survival Rate, pubmed-meshheading:11313668-Transplantation, Autologous, pubmed-meshheading:11313668-Transplantation Conditioning
pubmed:year
2001
pubmed:articleTitle
Autotransplants for Hodgkin's disease in first relapse or second remission: a report from the autologous blood and marrow transplant registry (ABMTR).
pubmed:affiliation
Department of Medicine, Ireland Cancer Center, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA.
pubmed:publicationType
Journal Article, Research Support, U.S. Gov't, P.H.S., Research Support, Non-U.S. Gov't