Abstract | BACKGROUND: PATIENTS AND METHODS: Forty-eight patients underwent aHSCT with either sequential TLI/ chemotherapy (n = 32) or chemotherapy-alone conditioning (n = 16), based on prior radiation exposure. The first 22 patients enrolled on trial received escalating doses of etoposide (1600-2100 mg/m(2)) with high-dose carboplatin and cyclophosphamide. RESULTS: No dose-limiting toxicity was seen and TLI/ chemotherapy was well tolerated. The 5-year event-free survival (EFS) estimate for all patients was 44% with overall survival (OS) of 48%. Five-year EFS and OS for the TLI/ chemotherapy group was 63% and 61%, respectively, compared with 6% and 27%, respectively, for the chemotherapy-alone group (P < 0.0001 and P = 0.04, respectively). Patients with primary induction failure HL who received TLI/ chemotherapy had 5-year EFS and OS rate of 83%. The 100-day treatment-related mortality was 4.2% and two secondary cancers were seen. Significant factors predicting survival by multivariate analysis included TLI/ chemotherapy conditioning and B symptoms at relapse. CONCLUSIONS: Sequential TLI/ chemotherapy conditioning for relapsed/refractory HL is safe and associated with excellent long-term survival rates.
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Authors | A M Evens, J K Altman, B B Mittal, N Hou, A Rademaker, D Patton, L Kaminer, S Williams, S Duffey, D Variakojis, S Singhal, M S Tallman, J Mehta, J N Winter, L I Gordon |
Journal | Annals of oncology : official journal of the European Society for Medical Oncology
(Ann Oncol)
Vol. 18
Issue 4
Pg. 679-88
(Apr 2007)
ISSN: 0923-7534 [Print] England |
PMID | 17307757
(Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article, Research Support, N.I.H., Extramural)
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Topics |
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Combined Modality Therapy
- Female
- Hematopoietic Stem Cell Transplantation
- Hodgkin Disease
(mortality, therapy)
- Humans
- Lymphatic Irradiation
- Male
- Middle Aged
- Prognosis
- Prospective Studies
- Recurrence
- Transplantation, Autologous
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