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Tandem high‐dose chemotherapy and autologous stem cell transplantation in refractory/relapsed Hodgkin's lymphoma: A monocenter prospective study
Author(s) -
Castagna Luca,
Magagnoli Massimo,
Balzarotti Monica,
Sarina Barbara,
Siracusano Licia,
Nozza Andrea,
Todisco Elisabetta,
Bramanti Stefania,
Mazza Rita,
Russo Filippo,
Timofeeva Inna,
Santoro Armando
Publication year - 2007
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20790
Subject(s) - medicine , chemotherapy , refractory (planetary science) , autologous stem cell transplantation , transplantation , lymphoma , hematopoietic stem cell transplantation , stem cell , oncology , non hodgkin's lymphoma , prospective cohort study , surgery , physics , astrobiology , biology , genetics
We designed a prospective study to evaluate the feasibility and efficacy of tandem high‐dose chemotherapy (HDCT) in the treatment of refractory or relapsed Hodgkin's lymphoma (HL). Thirty‐two patients were treated with salvage chemotherapy (IGEV, ifosfamide, gemcitabine, and vinorelbine) and chemo‐sensitive patients received a first HDCT course with melphalan 200 mg/m 2 (MEL200) and a second BEAM course. The median time interval between the two HDCT courses was 66 days. The median number of reinfused CD34 + cells was 4.7 x 10 6 /kg after MEL200 and 5.8 x 10 6 /kg after BEAM. The hematological reconstitution after both HDCT courses did not differ. No grade III or IV renal, hepatic, lung, cardiac, and neurological toxicity was observed. Severe (grade III and IV) oral mucositis was the most prominent complication affecting 60 and 50% of patients after MEL200 and BEAM, respectively. Fever of unknown origin occurred in 65 and 70% of patients after MEL200 and BEAM, respectively. One patient died from septic shock during the aplasia period following BEAM. In an intention‐to‐treat analysis, the overall response rate increased after each stage of protocol, ranging from 47% to 65% and 75% after IGEV, MEL200, and BEAM, respectively. Tandem HDCT is feasible and effective in patients with relapsed or refractory HL. Am. J. Hematol. 2006. © 2006 Wiley‐Liss, Inc.