Treatment for primary refractory Hodgkin's disease: a comparison of high-dose chemotherapy followed by ASCT with conventional therapy
| Autor: | Piotr Smolewski, Jerzy Holowiecki, Wanda Knopinska-Posluszny, Jolanta Gozdzik, Arnon Nagler, T. Zemelka, L. Kachel, Andrzej Hellmann, Tadeusz Robak, W.W. Jędrzejczak, Marek Z. Wojtukiewicz, M. Pawlicki, Richard Szydlo, Michal Osowiecki, Jan Walewski, Grzegorz Charliński, Jaroslaw Czyz, Z. Sawicki, Abraham Avigdor, J. Hansz |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning Adolescent medicine.medical_treatment Disease Gastroenterology High dose chemotherapy Autologous stem-cell transplantation Refractory Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Child Bone Marrow Transplantation Retrospective Studies Salvage Therapy Transplantation Chemotherapy Univariate analysis business.industry Hematology Middle Aged Prognosis medicine.disease Hodgkin Disease Survival Analysis Lymphoma Surgery Multivariate Analysis Refractory Hodgkin's Disease Female business |
| Zdroj: | Bone Marrow Transplantation. 33:1225-1229 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/sj.bmt.1704508 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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