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

PURPOSE:: To determine the activity of paclitaxel (Taxol® Bristol-MyersSquibb Co., Princeton, NJ) in patients with relapsed and primarytreatment-refractory Hodgkin's disease. PATIENTS AND METHODS:: 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 threehours every three weeks. All patients also received premedicationwith dexamethasone, cimetidine, and diphenhydramine. The medianage was 33 years (range, 19 to 69 years), and the median numberof prior treatment regimens was three. Seven patients had previouslyreceived treatment with autologous bone marrow transplantation. RESULTS:: Fourteen patients were evaluable for response after receivingone to six courses (median, two courses) of paclitaxel. Twopatients (14%) had partial remissions; both of them had relapsedafter achieving a complete remission with high-dose therapyand autologous bone marrow transplantation. One of these patientswas given involved field radiation to consolidate the partialremission and remains free of disease two years after paclitaxeltherapy. Three patients had stable disease, and nine had progressivedisease. Therapy was well tolerated, with a toxicity profilesimilar to that previously reported for paclitaxel in patientswith non-Hodgkin's lymphoma. CONCLUSION:: Paclitaxel, at this dose and schedule, has modest activity inthis group of heavily pretreated patients. Studying its activityin patients with more favorable disease characteristics is warranted. Hodgkin's disease, lymphoma, paclitaxel, Taxol