TY - JOUR
T1 - Treatment for primary refractory Hodgkin's disease
T2 - A comparison of high-dose chemotherapy followed by ASCT with conventional therapy
AU - Czyz, J.
AU - Szydlo, R.
AU - Knopinska-Posluszny, W.
AU - Hellmann, A.
AU - Gozdzik, J.
AU - Hansz, J.
AU - Smolewski, P.
AU - Robak, T.
AU - Osowiecki, M.
AU - Walewski, J.
AU - Avigdor, A.
AU - Nagler, A.
AU - Zemelka, T.
AU - Pawlicki, M.
AU - Sawicki, Z.
AU - Wojtukiewicz, M.
AU - Kachel, L.
AU - Holowiecki, J.
AU - Charlinski, G.
AU - Jedrzejczak, W. W.
PY - 2004/6
Y1 - 2004/6
N2 - 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.
AB - 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.
KW - Autologous stem cell transplantation
KW - High-dose chemotherapy
KW - Primary refractory Hodgkin's disease
UR - http://www.scopus.com/inward/record.url?scp=3242703317&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1704508
DO - 10.1038/sj.bmt.1704508
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C2 - 15094747
AN - SCOPUS:3242703317
SN - 0268-3369
VL - 33
SP - 1225
EP - 1229
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 12
ER -
