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British Journal of Cancer logoLink to British Journal of Cancer
. 1994 Sep;70(3):526–530. doi: 10.1038/bjc.1994.339

Single high-dose etoposide and melphalan with non-cryopreserved autologous marrow rescue as primary therapy for relapsed, refractory and poor-prognosis Hodgkin's disease.

L K Seymour 1, R D Dansey 1, W R Bezwoda 1
PMCID: PMC2033336  PMID: 8080741

Abstract

A simplified schedule of high-dose chemotherapy (HDC) consisting of melphalan (140 mg m-2) plus VP16 (2.5 g m-2) given over 12-18 h together with autologous non-cryopreserved autologous bone marrow transplant (ABMT) was used for treatment of relapsed (37 patients) and refractory (seven patients) patients and as first-line treatment (four patients) for poor-prognosis Hodgkin's disease. Two patients had a second HDC-ABMT after relapse following prior HDC-ABMT, giving a total of 50 procedures among 48 patients. The haematological recovery rate was 98% with a complete response rate of the Hodgkin's disease of > 90%. Factors significantly influencing response rate were performance status and the presence of liver involvement. Thirty-nine patients are alive, with 37 in continuous complete remission. The median duration of survival and median duration of remission have not been reached at a median follow-up time of 45 months. Adverse prognostic factors for survival were disease status at the time of HDC-ABMT (refractory versus relapse, with primarily refractory patients showing significantly poor survival) and the presence of liver involvement. High-dose chemotherapy with short-duration chemotherapy and non-cryopreserved bone marrow is an effective and safe treatment modality for patients with relapsed and poor-prognosis Hodgkin's disease.

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Selected References

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  1. Carella A. M., Santini G., Santoro A., Coser P., Frassoni F., Martinengo M., Nati S., Congiu A., Giordano D., Cerri R. Massive chemotherapy with non-frozen autologous bone marrow transplantation in 13 cases of refractory Hodgkin's disease. Eur J Cancer Clin Oncol. 1985 May;21(5):607–613. doi: 10.1016/0277-5379(85)90089-6. [DOI] [PubMed] [Google Scholar]
  2. Chao N. J., Tierney D. K., Bloom J. R., Long G. D., Barr T. A., Stallbaum B. A., Wong R. M., Negrin R. S., Horning S. J., Blume K. G. Dynamic assessment of quality of life after autologous bone marrow transplantation. Blood. 1992 Aug 1;80(3):825–830. [PubMed] [Google Scholar]
  3. Chopra R., McMillan A. K., Linch D. C., Yuklea S., Taghipour G., Pearce R., Patterson K. G., Goldstone A. H. The place of high-dose BEAM therapy and autologous bone marrow transplantation in poor-risk Hodgkin's disease. A single-center eight-year study of 155 patients. Blood. 1993 Mar 1;81(5):1137–1145. [PubMed] [Google Scholar]
  4. Crump M., Smith A. M., Brandwein J., Couture F., Sherret H., Sutton D. M., Scott J. G., McCrae J., Murray C., Pantalony D. High-dose etoposide and melphalan, and autologous bone marrow transplantation for patients with advanced Hodgkin's disease: importance of disease status at transplant. J Clin Oncol. 1993 Apr;11(4):704–711. doi: 10.1200/JCO.1993.11.4.704. [DOI] [PubMed] [Google Scholar]
  5. Fisher R. I., DeVita V. T., Hubbard S. P., Simon R., Young R. C. Prolonged disease-free survival in Hodgkin's disease with MOPP reinduction after first relapse. Ann Intern Med. 1979 May;90(5):761–763. doi: 10.7326/0003-4819-90-5-761. [DOI] [PubMed] [Google Scholar]
  6. Gribben J. G., Goldstone A. H., Linch D. C. Preliminary results of autologous bone marrow transplantation in the management of resistant Hodgkin's disease: experience of the Bloomsbury Transplant Group at University College, London. Recent Results Cancer Res. 1989;117:242–245. doi: 10.1007/978-3-642-83781-4_27. [DOI] [PubMed] [Google Scholar]
  7. Straus D. J., Gaynor J. J., Myers J., Merke D. P., Caravelli J., Chapman D., Yahalom J., Clarkson B. D. Prognostic factors among 185 adults with newly diagnosed advanced Hodgkin's disease treated with alternating potentially noncross-resistant chemotherapy and intermediate-dose radiation therapy. J Clin Oncol. 1990 Jul;8(7):1173–1186. doi: 10.1200/JCO.1990.8.7.1173. [DOI] [PubMed] [Google Scholar]
  8. Sullivan K. M., Appelbaum F. R., Horning S. J., Rosenberg S. A., Thomas E. D. Selection of patients with Hodgkin's disease and non-Hodgkin's lymphoma for bone marrow transplantation. Int J Cell Cloning. 1986;4 (Suppl 1):94–106. doi: 10.1002/stem.5530040711. [DOI] [PubMed] [Google Scholar]
  9. Taylor P. R., Jackson G. H., Lennard A. L., Lucraft H., Proctor S. J. Autologous transplantation in poor risk Hodgkin's disease using high dose melphalan/etoposide conditioning with non-cryopreserved marrow rescue. The Newcastle and Northern Region Lymphoma Group. Br J Cancer. 1993 Feb;67(2):383–387. doi: 10.1038/bjc.1993.70. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. To L. B., Roberts M. M., Haylock D. N., Dyson P. G., Branford A. L., Thorp D., Ho J. Q., Dart G. W., Horvath N., Davy M. L. Comparison of haematological recovery times and supportive care requirements of autologous recovery phase peripheral blood stem cell transplants, autologous bone marrow transplants and allogeneic bone marrow transplants. Bone Marrow Transplant. 1992 Apr;9(4):277–284. [PubMed] [Google Scholar]
  11. Vose J. M., Kennedy B. C., Bierman P. J., Kessinger A., Armitage J. O. Long-term sequelae of autologous bone marrow or peripheral stem cell transplantation for lymphoid malignancies. Cancer. 1992 Feb 1;69(3):784–789. doi: 10.1002/1097-0142(19920201)69:3<784::aid-cncr2820690328>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]

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