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Progressive disease after ABMT for Hodgkin's disease
B J Bolwell1, M Kalaycio, M Goormastic
1Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation, OH, USA.
Bone Marrow Transplantation
|January 7, 1998
Summary
Disease recurrence after autologous bone marrow transplantation (ABMT) for Hodgkin's disease is common. Tumor bulk at transplantation and time to relapse are key survival predictors, suggesting salvage therapy is beneficial.
Area of Science:
- Hematology
- Oncology
- Stem Cell Transplantation
Background:
- Autologous bone marrow transplantation (ABMT) is a treatment for relapsed/refractory Hodgkin's disease.
- Disease recurrence post-transplantation remains a significant challenge.
Purpose of the Study:
- To evaluate prognostic factors influencing survival after ABMT for Hodgkin's disease.
- To assess the impact of tumor bulk and time to relapse on patient outcomes.
Main Methods:
- Retrospective review of 68 patients undergoing ABMT between 1987 and 1993.
- Uniform preparatory regimen (CBV) used for all patients.
- Analysis of survival and progression-free survival based on clinical factors.
Main Results:
- Five-year overall and progression-free survival rates were 43% and 36%, respectively.
- Tumor bulk at transplantation was a significant poor prognostic factor (P=0.03 for OS, P=0.04 for PFS).
- Relapse occurring 7 or more months post-ABMT was associated with better survival compared to earlier relapse.
Conclusions:
- Tumor bulk and time to relapse are critical predictors of outcome after ABMT for Hodgkin's disease.
- Salvage therapy for post-transplant relapse can lead to prolonged survival in select patients.
- Further research into optimizing ABMT and post-transplant management is warranted.