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Comparison between conventional salvage therapy and high-dose therapy with
autografting for recurrent or refractory Hodgkin's disease
AR Yuen, SA Rosenberg, RT Hoppe, JD Halpern and SJ Horning
Department of Medicine, Stanford University Medical Center, CA, USA.
Sixty patients with Hodgkin's disease, refractory to or at first recurrence
after chemotherapy, received cytoreductive therapy followed by high-dose
etoposide, cyclophosphamide and either total body irradiation or carmustine
and autografting (median follow-up, 3.6 years; range, 1.1 to 7.5 years). A
matched conventional salvage group of 103 patients was selected from
patients treated at Stanford University Medical Center between January 1976
and January 1989 (median follow-up, 10.3 years; range, 3.0 to 15.7 years).
Overall survival (OS), event-free survival (EFS), and freedom from
progression (FFP) at 4 years follow-up favored patients who received
high-dose therapy compared with conventional salvage treatment (OS: 54% v
47%, P = .25; EFS: 53% v 27%, P < .01; FFP: 62% v 32%, P < .01). In
Cox regression analysis, response to cytoreductive or salvage therapy and B
symptoms at relapse were the most important predictors of OS. The use of
high- dose therapy at relapse, a longer duration of remission, and
favorable response to cytoreductive or salvage therapy were most predictive
of superior FFP and EFS. These data from a single institution comparing
conventional and high-dose therapy in matched patients demonstrate an
advantage for high-dose therapy and autografting in the sustained control
of Hodgkin's disease. As with primary therapy, it is difficult to
demonstrate a statistically significant survival advantage, despite an
apparently superior cure rate. However, patients failing induction therapy
or relapsing within 1 year benefited significantly from high- dose therapy
by all outcome measures (OS, EFS, FFP). As the transplant- related
mortality rates decline in Hodgkin's disease, it is predicted that cure
rates and late effects will become ultimate determinants of the success of
high-dose therapy and autografting.
Volume 89,
Issue 3,
pp. 814-822,
02/01/1997
Copyright © 1997 by The American Society of Hematology
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107(1):
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[Full Text]
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|
|
|
|
|
|
|
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|
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|
|
|
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|
|
|
|
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|
|
|
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|
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|
|
|
|
|
|
|
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[Full Text]
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|
|
|
|
|
|
|
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[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Santoro, H. Bredenfeld, L. Devizzi, H. Tesch, V. Bonfante, S. Viviani, F. Fiedler, H. S. Parra, C. Benoehr, M. Pacini, et al.
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18(13):
2615 - 2619.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
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18(5):
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[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Josting, M. Reiser, U. Rueffer, B. Salzberger, V. Diehl, and A. Engert
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18(2):
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[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. W. Sweetenham, A. M. Carella, G. Taghipour, D. Cunningham, R. Marcus, A. D. Volpe, D. C. Linch, N. Schmitz, and A. H. Goldstone
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17(10):
3101 - 3109.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. L. Grossbard
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August 1, 1999;
4(4):
287 - 292.
[Full Text]
|
|
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|
|
|
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March 1, 1999;
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825 - 825.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
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February 1, 1999;
17(2):
534 - 534.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. C. Aisenberg
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Blood,
February 1, 1999;
93(3):
761 - 779.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Andre, M. Henry-Amar, J.-L. Pico, P. Brice, D. Blaise, M. Kuentz, B. Coiffier, P. Colombat, J.-Y. Cahn, M. Attal, et al.
Comparison of High-Dose Therapy and Autologous Stem-Cell Transplantation With Conventional Therapy for Hodgkin's Disease Induction Failure: A Case-Control Study
J. Clin. Oncol.,
January 1, 1999;
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[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
