Protracted results of dose-intensive therapy using cyclophosphamide, carmustine, and continuous infusion etoposide with autologous stem cell support in patients with relapse or refractory Hodgkin's disease: A phase II study from the North American Marrow Transplant Group

Donald R. Fleming, Steven N. Wolff, Joseph W. Fay, Randy A. Brown, Joseph P. Lynch, Brian J. Bolwell, Don A. Stevens, Stacy A. Goodman, John P. Greer, Richard S. Stein, Luis A. Pineiro, Robert H. Collins, Linda Jane Goldsmith, Geoffrey P. Herzig, Roger H. Herzig

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

To determine the long-term results of high-dose chemotherapy and stem cell support in relapsed or primary refractory Hodgkin disease patients. One hundred and thirty-one patients with relapsed or primary refractory Hodgkin's disease were treated with a dose-intensive therapy protocol consisting of etoposide (2400 mg/m2 continuous intravenous infusion) cyclophosphamide (7200 mg/m2 intravenously), and carmustine (300-600 mg/m2 intravenously) CBVi. All patients had previously failed conventional chemoradiotherapy. Severe toxicities were related to infectious, hepatic, and pulmonary complications. Fatal, regimen-related toxicity was 19%; liver and lung dysfunction, as well as infection, were the most frequent problems. Ninety-one (69%) of the patients achieved a complete response (CR) (95% CI = 59% to 75%) after CBVi and autologous stem cell infusion. With a median follow-up of 5.1 years (range 3.0 to 9.5 years), overall and event-free survival are 44% (95% CI = 33% to 47%) and 38% (95% CI = 28% to 46%) respectively. While univariate analysis did not reveal a statistically significant variable to predict a better response, responsiveness to therapy demonstrated a trend. We conclude that CBVi is an effective therapy for relapsed or refractory Hodgkin's disease, producing long-term, durable remissions.

Original languageEnglish (US)
Pages (from-to)91-98
Number of pages8
JournalLeukemia and Lymphoma
Volume35
Issue number1-2
StatePublished - 1999

Fingerprint

Carmustine
Etoposide
Hodgkin Disease
Cyclophosphamide
Stem Cells
Bone Marrow
Transplants
Recurrence
Lung
Chemoradiotherapy
Therapeutics
Intravenous Infusions
Disease-Free Survival
Liver Diseases
Drug Therapy
Liver
Infection

Keywords

  • Autologous stem cell transplantation
  • High-dose chemotherapy
  • Hodgkins disease

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Protracted results of dose-intensive therapy using cyclophosphamide, carmustine, and continuous infusion etoposide with autologous stem cell support in patients with relapse or refractory Hodgkin's disease : A phase II study from the North American Marrow Transplant Group. / Fleming, Donald R.; Wolff, Steven N.; Fay, Joseph W.; Brown, Randy A.; Lynch, Joseph P.; Bolwell, Brian J.; Stevens, Don A.; Goodman, Stacy A.; Greer, John P.; Stein, Richard S.; Pineiro, Luis A.; Collins, Robert H.; Goldsmith, Linda Jane; Herzig, Geoffrey P.; Herzig, Roger H.

In: Leukemia and Lymphoma, Vol. 35, No. 1-2, 1999, p. 91-98.

Research output: Contribution to journalArticle

Fleming, DR, Wolff, SN, Fay, JW, Brown, RA, Lynch, JP, Bolwell, BJ, Stevens, DA, Goodman, SA, Greer, JP, Stein, RS, Pineiro, LA, Collins, RH, Goldsmith, LJ, Herzig, GP & Herzig, RH 1999, 'Protracted results of dose-intensive therapy using cyclophosphamide, carmustine, and continuous infusion etoposide with autologous stem cell support in patients with relapse or refractory Hodgkin's disease: A phase II study from the North American Marrow Transplant Group', Leukemia and Lymphoma, vol. 35, no. 1-2, pp. 91-98.
Fleming, Donald R. ; Wolff, Steven N. ; Fay, Joseph W. ; Brown, Randy A. ; Lynch, Joseph P. ; Bolwell, Brian J. ; Stevens, Don A. ; Goodman, Stacy A. ; Greer, John P. ; Stein, Richard S. ; Pineiro, Luis A. ; Collins, Robert H. ; Goldsmith, Linda Jane ; Herzig, Geoffrey P. ; Herzig, Roger H. / Protracted results of dose-intensive therapy using cyclophosphamide, carmustine, and continuous infusion etoposide with autologous stem cell support in patients with relapse or refractory Hodgkin's disease : A phase II study from the North American Marrow Transplant Group. In: Leukemia and Lymphoma. 1999 ; Vol. 35, No. 1-2. pp. 91-98.
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AU - Fleming, Donald R.

AU - Wolff, Steven N.

AU - Fay, Joseph W.

AU - Brown, Randy A.

AU - Lynch, Joseph P.

AU - Bolwell, Brian J.

AU - Stevens, Don A.

AU - Goodman, Stacy A.

AU - Greer, John P.

AU - Stein, Richard S.

AU - Pineiro, Luis A.

AU - Collins, Robert H.

AU - Goldsmith, Linda Jane

AU - Herzig, Geoffrey P.

AU - Herzig, Roger H.

PY - 1999

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N2 - To determine the long-term results of high-dose chemotherapy and stem cell support in relapsed or primary refractory Hodgkin disease patients. One hundred and thirty-one patients with relapsed or primary refractory Hodgkin's disease were treated with a dose-intensive therapy protocol consisting of etoposide (2400 mg/m2 continuous intravenous infusion) cyclophosphamide (7200 mg/m2 intravenously), and carmustine (300-600 mg/m2 intravenously) CBVi. All patients had previously failed conventional chemoradiotherapy. Severe toxicities were related to infectious, hepatic, and pulmonary complications. Fatal, regimen-related toxicity was 19%; liver and lung dysfunction, as well as infection, were the most frequent problems. Ninety-one (69%) of the patients achieved a complete response (CR) (95% CI = 59% to 75%) after CBVi and autologous stem cell infusion. With a median follow-up of 5.1 years (range 3.0 to 9.5 years), overall and event-free survival are 44% (95% CI = 33% to 47%) and 38% (95% CI = 28% to 46%) respectively. While univariate analysis did not reveal a statistically significant variable to predict a better response, responsiveness to therapy demonstrated a trend. We conclude that CBVi is an effective therapy for relapsed or refractory Hodgkin's disease, producing long-term, durable remissions.

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