Tandem high-dose chemotherapy and autologous stem cell transplantation in refractory/relapsed Hodgkin's lymphoma: A monocenter prospective study

Research output: Contribution to journalArticle

Abstract

We designed a prospective study to evaluate the feasibility and efficacy of tandem high-dose chemotherapy (HDCT) in the treatment of refractory or relapsed Hodgkin's lymphoma (HL). Thirty-two patients were treated with salvage chemotherapy (IGEV, ifosfamide, gemcitabine, and vinorelbine) and chemo-sensitive patients received a first HDCT course with melphalan 200 mg/m 2 (MEL200) and a second BEAM course. The median time interval between the two HDCT courses was 66 days. The median number of reinfused CD34 + cells was 4.7 × 10 6/kg after MEL200 and 5.8 × 10 6/kg after BEAM. The hematological reconstitution after both HDCT courses did not differ. No grade III or IV renal, hepatic, lung, cardiac, and neurological toxicity was observed. Severe (grade III and IV) oral mucositis was the most prominent complication affecting 60 and 50% of patients after MEL200 and BEAM, respectively. Fever of unknown origin occurred in 65 and 70% of patients after MEL200 and BEAM, respectively. One patient died from septic shock during the aplasia period following BEAM. In an intention-to-treat analysis, the overall response rate increased after each stage of protocol, ranging from 47% to 65% and 75% after IGEV, MEL200, and BEAM, respectively. Tandem HDCT is feasible and effective in patients with relapsed or refractory HL.

Original languageEnglish
Pages (from-to)122-127
Number of pages6
JournalAmerican Journal of Hematology
Volume82
Issue number2
DOIs
Publication statusPublished - Feb 2007

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Stem Cell Transplantation
Hodgkin Disease
Prospective Studies
gemcitabine
Drug Therapy
Ifosfamide
Fever of Unknown Origin
Stomatitis
Intention to Treat Analysis
Melphalan
Septic Shock
Kidney
Lung
Liver

Keywords

  • High-dose chemotherapy
  • Hodgkin's lymphoma
  • Tandem transplant

ASJC Scopus subject areas

  • Hematology

Cite this

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title = "Tandem high-dose chemotherapy and autologous stem cell transplantation in refractory/relapsed Hodgkin's lymphoma: A monocenter prospective study",
abstract = "We designed a prospective study to evaluate the feasibility and efficacy of tandem high-dose chemotherapy (HDCT) in the treatment of refractory or relapsed Hodgkin's lymphoma (HL). Thirty-two patients were treated with salvage chemotherapy (IGEV, ifosfamide, gemcitabine, and vinorelbine) and chemo-sensitive patients received a first HDCT course with melphalan 200 mg/m 2 (MEL200) and a second BEAM course. The median time interval between the two HDCT courses was 66 days. The median number of reinfused CD34 + cells was 4.7 × 10 6/kg after MEL200 and 5.8 × 10 6/kg after BEAM. The hematological reconstitution after both HDCT courses did not differ. No grade III or IV renal, hepatic, lung, cardiac, and neurological toxicity was observed. Severe (grade III and IV) oral mucositis was the most prominent complication affecting 60 and 50{\%} of patients after MEL200 and BEAM, respectively. Fever of unknown origin occurred in 65 and 70{\%} of patients after MEL200 and BEAM, respectively. One patient died from septic shock during the aplasia period following BEAM. In an intention-to-treat analysis, the overall response rate increased after each stage of protocol, ranging from 47{\%} to 65{\%} and 75{\%} after IGEV, MEL200, and BEAM, respectively. Tandem HDCT is feasible and effective in patients with relapsed or refractory HL.",
keywords = "High-dose chemotherapy, Hodgkin's lymphoma, Tandem transplant",
author = "Luca Castagna and Massimo Magagnoli and Monica Balzarotti and Barbara Sarina and Licia Siracusano and Andrea Nozza and Elisabetta Todisco and Stefania Bramanti and Rita Mazza and Filippo Russo and Inna Timofeeva and Armando Santoro",
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T1 - Tandem high-dose chemotherapy and autologous stem cell transplantation in refractory/relapsed Hodgkin's lymphoma

T2 - A monocenter prospective study

AU - Castagna, Luca

AU - Magagnoli, Massimo

AU - Balzarotti, Monica

AU - Sarina, Barbara

AU - Siracusano, Licia

AU - Nozza, Andrea

AU - Todisco, Elisabetta

AU - Bramanti, Stefania

AU - Mazza, Rita

AU - Russo, Filippo

AU - Timofeeva, Inna

AU - Santoro, Armando

PY - 2007/2

Y1 - 2007/2

N2 - We designed a prospective study to evaluate the feasibility and efficacy of tandem high-dose chemotherapy (HDCT) in the treatment of refractory or relapsed Hodgkin's lymphoma (HL). Thirty-two patients were treated with salvage chemotherapy (IGEV, ifosfamide, gemcitabine, and vinorelbine) and chemo-sensitive patients received a first HDCT course with melphalan 200 mg/m 2 (MEL200) and a second BEAM course. The median time interval between the two HDCT courses was 66 days. The median number of reinfused CD34 + cells was 4.7 × 10 6/kg after MEL200 and 5.8 × 10 6/kg after BEAM. The hematological reconstitution after both HDCT courses did not differ. No grade III or IV renal, hepatic, lung, cardiac, and neurological toxicity was observed. Severe (grade III and IV) oral mucositis was the most prominent complication affecting 60 and 50% of patients after MEL200 and BEAM, respectively. Fever of unknown origin occurred in 65 and 70% of patients after MEL200 and BEAM, respectively. One patient died from septic shock during the aplasia period following BEAM. In an intention-to-treat analysis, the overall response rate increased after each stage of protocol, ranging from 47% to 65% and 75% after IGEV, MEL200, and BEAM, respectively. Tandem HDCT is feasible and effective in patients with relapsed or refractory HL.

AB - We designed a prospective study to evaluate the feasibility and efficacy of tandem high-dose chemotherapy (HDCT) in the treatment of refractory or relapsed Hodgkin's lymphoma (HL). Thirty-two patients were treated with salvage chemotherapy (IGEV, ifosfamide, gemcitabine, and vinorelbine) and chemo-sensitive patients received a first HDCT course with melphalan 200 mg/m 2 (MEL200) and a second BEAM course. The median time interval between the two HDCT courses was 66 days. The median number of reinfused CD34 + cells was 4.7 × 10 6/kg after MEL200 and 5.8 × 10 6/kg after BEAM. The hematological reconstitution after both HDCT courses did not differ. No grade III or IV renal, hepatic, lung, cardiac, and neurological toxicity was observed. Severe (grade III and IV) oral mucositis was the most prominent complication affecting 60 and 50% of patients after MEL200 and BEAM, respectively. Fever of unknown origin occurred in 65 and 70% of patients after MEL200 and BEAM, respectively. One patient died from septic shock during the aplasia period following BEAM. In an intention-to-treat analysis, the overall response rate increased after each stage of protocol, ranging from 47% to 65% and 75% after IGEV, MEL200, and BEAM, respectively. Tandem HDCT is feasible and effective in patients with relapsed or refractory HL.

KW - High-dose chemotherapy

KW - Hodgkin's lymphoma

KW - Tandem transplant

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