Preliminary experience with paclitaxel for the treatment of relapsed and refractory Hodgkin's disease

To determine the activity of paclitaxel (Taxol; Bristol-Myers Squibb Co., Princeton, NJ) in patients with relapsed and primary treatment-refractory Hodgkin's disease.

Fifteen patients with relapsed (n = 8) or primary treatment-refractory (n = 7) Hodgkin's disease were treated at two cancer centers. Patients received paclitaxel 200 mg/m2 intravenously over three hours every three weeks. All patients also received premedication with dexamethasone, cimetidine, and diphenhydramine. The median age was 33 years (range 19 to 69 years), and the median number of prior treatment regimens was three. Seven patients had previously received treatment with autologous bone marrow transplantation.

Fourteen patients were evaluable for response after receiving one to six courses (median, two courses) of paclitaxel. Two patients (14%) had partial remissions; both of them had relapsed after achieving a complete remission with high-dose therapy and autologous bone marrow transplantation. One of these patients was given involved field radiation to consolidate the partial remission and remains free of disease two years after paclitaxel therapy. Three patients had stable disease, and nine had progressive disease. Therapy was well tolerated, with a toxicity profile similar to that previously reported for paclitaxel in patients with non-Hodgkin's lymphoma.

Paclitaxel, at this dose and schedule, has modest activity in this group of heavily pretreated patients. Studying its activity in patients with more favorable disease characteristics is warranted.