Duarte BKL, Valente I, Vigorito AC, Aranha FJP, Oliveira-Duarte G, Miranda ECM, Lorand-Metze I, Pagnano KB, Delamain M, Marques Junior JF, Brandalise SR, Nucci M, De Souza CA. Brazilian experience using high-dose sequential chemotherapy followed by autologous hematopoietic stem cell transplantation for relapsed or refractory Hodgkin lymphoma.
ACTA ACUST UNITED AC 2009;
9:449-54. [PMID:
19951885 DOI:
10.3816/clm.2009.n.088]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE
We evaluate the effectiveness and toxicity of high-dose sequential chemotherapy (HDS) as salvage therapy in patients with advanced-stage Hodgkin lymphoma.
PATIENTS AND METHODS
We performed a retrospective analysis on 77 patients receiving HDS between 1998 and 2006. Patients enrolled were in disease progression or relapsed disease, or did not achieve a complete remission after first-line treatment. HDS consisted of the sequential administration of cyclophosphamide and granulocyte colony-stimulating factor with stem cell harvesting, followed by methotrexate plus vincristine and etoposide.
RESULTS
The majority of patients had stage III/IV (64%) and B symptoms (71.4%). Disease status improvement after HDS was observed in 24 of 57 patients (42%) previously in disease progression or relapse. HDS-related deaths occurred in 8 of 77 patients (10.4%). Four patients (5.2%) developed acute myeloid leukemia/myelodysplastic syndrome. Overall, disease-free and progression-free survival was 27%, 57%, and 25%, respectively.
CONCLUSION
Despite the treatment-related mortality, HDS is feasible, with satisfactory response rates, even in patients with poor prognosis.
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