High-dose chemotherapy followed by autologous hematopoietic rescue for Hodgkin's disease patients following first relapse after chemotherapy

Background: The best results of conventional-dose salvage chemotherapyfor Hodgkin's disease have been reported after first relapse.We evaluated the results of high-dose chemotherapy and autologoushematopoietic rescue for Hodgkin's disease patients who hadrelapsed from an initial chemotherapy-induced complete remission. Patients and methods: Eighty-five patients received high-dosecyclophosphamide, carmustine, and etoposide (CBV) followed byautologous bone marrow or peripheral blood stem cell transplantation. Results: Actuarial survival at five years was 51%, and failure-freesurvival was 40%. Failure-free survival at five years was 90%for patients who received no conventional-dose salvage chemotherapyprior to CBV. Failure-free survival of patients treated initiallywith a four-drug regimen was not significantly different thanpatients treated with seven/eight-drug regimens. Conclusion: These results appear to be better than those reportedfor conventional-dose salvage chemotherapy. High-dose therapyfollowed by autologous bone marrow or peripheral blood stemcell transplantation should be considered for any patient withrelapsed Hodgkin's disease, regardless of the length of initialremission, or type of initial chemotherapy. Certain patients,especially those with minimal disease, may benefit by proceedingdirectly to transplantation after relapse, without first receivingconventional-dose salvage chemotherapy. bone marrow transplantation, drug therapy, hematopoietic stem cell transplantation, Hodgkin's disease