Effectiveness of high dose chemoradiotherapy and autologous stem cell transplantation for patients with biopsy-proven primary refractory Hodgkin's disease

Craig H. Moskowitz, Tarun Kewalramani, Stephen D. Nimer, Maria Gonzalez, Andrew D. Zelenetz, Joachim Yahalom

Research output: Contribution to journalArticle

126 Scopus citations

Abstract

Prospective randomized studies have determined that high dose therapy and autologous stem cell transplantation (ASCT) is the standard treatment for patients with chemosensitive relapsed Hodgkin's disease (HD); however, the role of this approach in patients with primary refractory disease has been controversial. This report is an integrated analysis of 75 consecutive patients with biopsy-confirmed primary refractory HD, who were treated with high dose chemoradiotherapy (HDT) and ASCT at the Memorial Sloan Kettering Cancer Center. The patients underwent conventional dose cytoreductive chemotherapy followed by HDT and ASCT. At a median follow-up of 10 years for surviving patients, the event-free survival (EFS), progression-free survival (PFS) and overall survival (OS) rates were 45%, 49% and 48% respectively. Only chemosensitivity to standard-dose second-line chemotherapy (SDSC) predicted for a better survival, thus responding patients had an EFS, PFS and OS of 60%, 62% and 66%, respectively, versus 19%, 23% and 17% for patients who had a poor response to SDSC (P < 0.001). While patients with chemosensitive disease have an excellent outcome with HDT and ASCT, novel approaches are needed to cure HD patients who fail front-line and second-line chemotherapy.

Original languageEnglish (US)
Pages (from-to)645-652
Number of pages8
JournalBritish Journal of Haematology
Volume124
Issue number5
DOIs
StatePublished - Mar 1 2004
Externally publishedYes

Keywords

  • ASCT
  • Biopsy-proven
  • Chemosensitive
  • Hodgkin's Disease
  • Refractory

ASJC Scopus subject areas

  • Hematology

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