| Evaluation of cytoreductive therapy prior to high dose treatment with autologous bone marrow transplantation in relapsed and refractory Hodgkin's disease. | |
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MedLine Citation:
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PMID: 2310878 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Based on observations that bulky disease at autologous bone marrow transplantation (ABMT) may be correlated with poor outcome in Hodgkin's disease, we have assessed the ability of conventional-dose chemoradiotherapy to reduce tumour burden to a minimum prior to ABMT. Thirty-seven patients with relapsed or refractory Hodgkin's disease referred for intensive therapy and ABMT were treated initially with one to five cycles of DHAP chemotherapy. All patients had previously received MOPP and ABVD chemotherapy or similar regimens. Four patients achieved complete remission (CR) and 12 partial remission (PR), for a total response rate of 43%. Eight partial responders and four non-responders to DHAP achieved significant further tumour reduction with local radiotherapy (five CR, seven PR). Six of 10 non-responders to DHAP responded to alternative salvage chemotherapy (mini-BEAM, CEP or augmented CVP). Overall, 24/37 patients (65%) achieved effective cytoreduction (nine CR, 15 PR with minimal disease) and have proceeded to ABMT. Patients with bulky disease at relapse or limited stage (II, IIIA) at diagnosis were less likely to respond to DHAP, but some of these could be cytoreduced with alternative therapy. In addition, the number of prior chemotherapy regimens correlated inversely with likelihood of response to DHAP. The results indicate that approximately two-thirds of patients with Hodgkin's disease who relapse after MOPP and ABVD-like regimens can achieve effective cytoreduction with conventional-dose chemoradiotherapy and proceed to ABMT in CR or PR with minimal disease. |
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Authors:
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J M Brandwein; J Callum; S B Sutcliffe; J G Scott; A Keating |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Bone marrow transplantation Volume: 5 ISSN: 0268-3369 ISO Abbreviation: Bone Marrow Transplant. Publication Date: 1990 Feb |
Date Detail:
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Created Date: 1990-04-20 Completed Date: 1990-04-20 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8702459 Medline TA: Bone Marrow Transplant Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 99-103 Citation Subset: IM |
Affiliation:
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University of Toronto Autologous Bone Marrow Transplant Program, Toronto General Hospital, Ontario, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Antineoplastic Combined Chemotherapy Protocols / therapeutic use* Bone Marrow Transplantation* Carmustine / administration & dosage Chi-Square Distribution Cisplatin / administration & dosage Combined Modality Therapy Cyclophosphamide / administration & dosage Cytarabine / administration & dosage Dexamethasone / administration & dosage Epirubicin / administration & dosage Etoposide / administration & dosage Evaluation Studies as Topic Hodgkin Disease / drug therapy*, surgery Humans Male Melphalan / administration & dosage Prednisone / administration & dosage Premedication* Remission Induction Vincristine / administration & dosage |
| Chemical | |
Reg. No./Substance:
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0/BEAM regimen; 0/CEP combination; 0/COP protocol 2; 0/DHAP protocol; 147-94-4/Cytarabine; 148-82-3/Melphalan; 154-93-8/Carmustine; 15663-27-1/Cisplatin; 33419-42-0/Etoposide; 50-02-2/Dexamethasone; 50-18-0/Cyclophosphamide; 53-03-2/Prednisone; 56420-45-2/Epirubicin; 57-22-7/Vincristine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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