High Dose Therapy with Autologous Stem Cell Transplantation in Patients with Hodgkin’s Lymphoma: Long Term Follow-up in Patients Treated in One Center
Authors:
M. Trněný 1; B. Vacková 1; R. Pytlík 1; P. Cieslar 1; V. Válková 1,2; Z. Gašová 2; P. Kobylka 2; M. Trnková 1; H. Krejčová 1; P. Klener 1,2
Authors‘ workplace:
I. interní klinika 1. LF UK a VFN, Praha
1; Ústav hematologie a krevní transfuze, Praha
2
Published in:
Čas. Lék. čes. 2006; 145: 19-24
Category:
Original Article
Overview
Backround.
Majority of patients with Hodgkin’s Lymphoma (HL) can be cured by first line therapy. The high dose therapy (HDT) with autologous stem cell transplantation (ASCT) is the option which can be used in the situation when the conventional therapy failed.
Methods and Results.
Beginning 1994 till 2005 84 pts with HL who did not respond the conventional chemotherapy underwent 105 HDT procedures with ASCT. The median age at the time of HDT was 30.5 years. The reason for salvage therapy followed by HDT with ASCT was the failure to achieve 1st complete remission - CR (n 16) or the subsequent relapse or progression (n 68). The disease status at the time of HDT after conventional salvage chemotherapy was assessed as chemosensitive in 65 pts (77.4 %) and chemoresistant in 19 pts (22.6 %). The most frequent HDT regimen used was BEAM (82 HDT), 22 pts entered into the tandem HDT program. Bone marrow only was used as the source of progenitor cells in 4 ASCT, peripheral blood progenitor cells (PBPC) only were used in 85 ASCT and the combination of both in 16 ASCT. The disease status after the HDT with ASCT was assessed (77 pts were qualifiable) as CR in 39 pts (50.6 %), PR in 31 (40.3%) and as stable disease or progression in 7 pts (9.1 %). Treatment related mortality in HDT with PBPC was 3.9 %. The median follow up is 5.3 years. The five year probability of event free survival (EFS) is 43.1 % and overall survival 53.2 %. The EFS and OS probability respectively for the chemosensitive patients was 48.6 % and 62.9 % respectively. The status at HDT and the results after it have prognostic significance. There were observed 39 deaths and 26 of them were caused by disease progression. Secondary tumor was observed in 5 pts and in all of them it caused the death.
Conclusions.
The HDT with ASCT allows the long term survival without disease progression in about a half of the patients with reasonable toxicity.
Key words:
Hodgkin’s Lymphoma, transplantation, high dose therapy.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
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