High-dose chemotherapy and autologous bone marrow transplant in relapsed Hodgkin's disease - A pragmatic prognostic index

Authors: O'Brien, M.E.R., Milan, S., Cunningham, D., Jones, A.L., Nicolson, M., Selby, P., Hickish, T., Hill, M., Gore, M.E. and Viner, C.

Journal: British Journal of Cancer

Volume: 73

Issue: 10

Pages: 1272-1277

ISSN: 0007-0920

DOI: 10.1038/bjc.1996.244

Abstract:

High-dose chemotherapy with autologous bone marrow transplantation is used in the treatment of relapsed or high-risk Hodgkin's disease. As prospective randomised studies have proved difficult to accrue to, current recommendations are based on the reports of large series of prospectively collected data. We have looked at the outcome of 89 patients treated in this way at a single institution and have developed an index to predict outcome. Of 89 patients, with a median age of 29 years (range 15-51 years), eight patients were in first complete remission/partial remission (CR/PR), 17 in second or later CR, 37 were responding relapses, 13 resistant relapses, 11 primary refractory and three untested relapses. Combinations of melphalan, BCNU and etoposide were given in all cases except in ten patients who received melphalan alone. The median follow-up was 43 months (range 6-77 months). A total of 24 patients were in CR at the time of autologous bone marrow transplantation (ABMT), 33 achieved CR with ABMT, 16 PR, to give a response rate to ABMT of 49/65 = 74% (95% CI 60-83%) with a CR rate of 51% (CI 36-62%). In a Cox's multivariate analysis the most important factors in predicting outcome after ABMT were response to treatment before entry, number of previous treatments and previous chemosensitivity. Using these factors we devised a prognostic index which reliably selects a group of patients (65%) with at least a 70% chance of being progression free from 1 year onwards. Patients who have never achieved a CR and have received three or more chemotherapy regimens do not benefit from high-dose chemotherapy as used in this study.

Source: Scopus

High-dose chemotherapy and autologous bone marrow transplant in relapsed Hodgkin's disease--a pragmatic prognostic index.

Authors: O'Brien, M.E., Milan, S., Cunningham, D., Jones, A.L., Nicolson, M., Selby, P., Hickish, T., Hill, M., Gore, M.E. and Viner, C.

Journal: Br J Cancer

Volume: 73

Issue: 10

Pages: 1272-1277

ISSN: 0007-0920

DOI: 10.1038/bjc.1996.244

Abstract:

High-dose chemotherapy with autologous bone marrow transplantation is used in the treatment of relapsed or high-risk Hodgkin's disease. As prospective randomised studies have proved difficult to accrue to, current recommendations are based on the reports of large series of prospectively collected data. We have looked at the outcome of 89 patients treated in this way at a single institution and have developed an index to predict outcome. Of 89 patients, with a median age of 29 years (range 15-51 years), eight patients were in first complete remission/partial remission (CR/PR), 17 in second or later CR, 37 were responding relapses, 13 resistant relapses, 11 primary refractory and three untested relapses. Combinations of melphalan, BCNU and etoposide were given in all cases except in ten patients who received melphalan alone. The median follow-up was 43 months (range 6-77 months). A total of 24 patients were in CR at the time of autologous bone marrow transplantation (ABMT), 33 achieved CR with ABMT, 16 PR, to give a response rate to ABMT of 49/65 = 74% (95% CI 60-83%) with a CR rate of 51% (CI 36-62%). In a Cox's multivariate analysis the most important factors in predicting outcome after ABMT were response to treatment before entry, number of previous treatments and previous chemosensitivity. Using these factors we devised a prognostic index which reliably selects a group of patients (65%) with at least a 70% chance of being progression free from 1 year onwards. Patients who have never achieved a CR and have received three or more chemotherapy regimens do not benefit from high-dose chemotherapy as used in this study.

Source: PubMed

Preferred by: Tamas Hickish

High-dose chemotherapy and autologous bone marrow transplant in relapsed Hodgkin's disease - A pragmatic prognostic index

Authors: OBrien, M.E.R., Milan, S., Cunningham, D., Jones, A.L., Nicolson, M., Selby, P., Hickish, T., Hill, M., Gore, M.E. and Viner, C.

Journal: BRITISH JOURNAL OF CANCER

Volume: 73

Issue: 10

Pages: 1272-1277

eISSN: 1532-1827

ISSN: 0007-0920

DOI: 10.1038/bjc.1996.244

Source: Web of Science (Lite)

High-dose chemotherapy and autologous bone marrow transplant in relapsed Hodgkin's disease--a pragmatic prognostic index.

Authors: O'Brien, M.E., Milan, S., Cunningham, D., Jones, A.L., Nicolson, M., Selby, P., Hickish, T., Hill, M., Gore, M.E. and Viner, C.

Journal: British journal of cancer

Volume: 73

Issue: 10

Pages: 1272-1277

eISSN: 1532-1827

ISSN: 0007-0920

DOI: 10.1038/bjc.1996.244

Abstract:

High-dose chemotherapy with autologous bone marrow transplantation is used in the treatment of relapsed or high-risk Hodgkin's disease. As prospective randomised studies have proved difficult to accrue to, current recommendations are based on the reports of large series of prospectively collected data. We have looked at the outcome of 89 patients treated in this way at a single institution and have developed an index to predict outcome. Of 89 patients, with a median age of 29 years (range 15-51 years), eight patients were in first complete remission/partial remission (CR/PR), 17 in second or later CR, 37 were responding relapses, 13 resistant relapses, 11 primary refractory and three untested relapses. Combinations of melphalan, BCNU and etoposide were given in all cases except in ten patients who received melphalan alone. The median follow-up was 43 months (range 6-77 months). A total of 24 patients were in CR at the time of autologous bone marrow transplantation (ABMT), 33 achieved CR with ABMT, 16 PR, to give a response rate to ABMT of 49/65 = 74% (95% CI 60-83%) with a CR rate of 51% (CI 36-62%). In a Cox's multivariate analysis the most important factors in predicting outcome after ABMT were response to treatment before entry, number of previous treatments and previous chemosensitivity. Using these factors we devised a prognostic index which reliably selects a group of patients (65%) with at least a 70% chance of being progression free from 1 year onwards. Patients who have never achieved a CR and have received three or more chemotherapy regimens do not benefit from high-dose chemotherapy as used in this study.

Source: Europe PubMed Central