Hodgkin's disease: the role of bone marrow transplantation

Because results with conventional salvage therapy remain disappointing, the approach of using high-dose therapy and bone marrow transplantation has gained increasing support in recent years. Several trials have now been reported using various conditioning regimens and hematopoietic rescue sources. Although it is not clear which high-dose chemotherapy is the best conditioning regimen, many of the trials contain patients who are long-term disease-free survivors using this therapeutic approach. As more experience is gained with this therapy, the patient population for which it offers the best results will be better defined. High-dose therapy and bone marrow transplantation has been shown to offer better long-term disease-free survival to patients who are transplanted after failing one or two chemotherapy regimens, have good performance status, and still have chemotherapy-sensitive disease. For research to continue in this area, it is important that patients who are otherwise eligible for high-dose therapy and bone marrow transplantation participate in clinical trials to address the unanswered questions concerning high-dose therapy and bone marrow transplantation.