Treatment for primary refractory Hodgkin's disease: A comparison of high-dose chemotherapy followed by ASCT with conventional therapy

J. Czyz, R. Szydlo, W. Knopinska-Posluszny, A. Hellmann, J. Gozdzik, J. Hansz, P. Smolewski, T. Robak, M. Osowiecki, J. Walewski, A. Avigdor, A. Nagler, T. Zemelka, M. Pawlicki, Z. Sawicki, M. Wojtukiewicz, L. Kachel, J. Holowiecki, G. Charlinski, W. W. Jedrzejczak

Research output: Contribution to journalArticlepeer-review

Abstract

Our previously published study showed promising results of autologous stem cell transplantation (ASCT) in patients with primary resistant Hodgkin's disease (HD). Probabilities of overall survival (OS) and progression-free survival (PFS) at 3 years were 55 and 36%, respectively. The present study was undertaken to compare these results with conventionally treated patients and thus evaluate therapeutic options. Retrospective data on 76 adult patients who underwent ASCT were matched with 76 conventionally treated patients from 17 centers. Comparison of clinical characteristics in both groups showed that ASCT patients were younger (24 vs 31.5 years, P = 0.001), more frequently presented with 'B' symptoms (P = 0.03) and that more patients treated with chemotherapy (CT) had elevated LDH (P = 0.03). In univariate analyses, bulky disease (P = 0.0043) and complete resistance to standard CT (P = 0.051) were found to be risk factors for OS. In a multivariate survival analysis only bulky disease was found to an independent prognostic factor (P = 0.005). There was no difference in survival between the treatment groups with 5 years OS 33.7 (CI: 23-46) in the ASCT group and 35.6% (CI: 25-50) for the CT group (P = 0.92). We conclude that ASCT is not superior to standard CT for treatment of patients with primary refractory HD.

Original languageEnglish
Pages (from-to)1225-1229
Number of pages5
JournalBone Marrow Transplantation
Volume33
Issue number12
DOIs
StatePublished - Jun 2004
Externally publishedYes

Keywords

  • Autologous stem cell transplantation
  • High-dose chemotherapy
  • Primary refractory Hodgkin's disease

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