Autologous bone marrow transplantation for patients with relapsed hodgkin's disease

James O. Armitage, Philip J. Bierman, Julie M. Vose, James R. Anderson, Dennis D. Weisenburger, Anne Kessinger, Elizabeth C. Reed, William P. Vaughan, Peter F. Coccia, David T. Purtilo

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Abstract

purpose: High-dose therapy and autologous bone marrow transplantation (ABMT) are being increasingly utilized for the management of patients with relapsed Hodgkin's disease. Because patients with relapsed Hodgkin's disease often initially respond to salvage chemotherapy regimens, ABMT is frequently delayed until late in the course of the disease. The optimal timing for ABMT has not been identified. The purpose of this study was to determine the value of ABMT earlier in the course of Hodgkin's disease. patients and methods: We treated 70 patients between October 1984 and October 1988 with high-dose cyclophosphamide, carmustine, and etoposide, followed by infusion of previously cryopreserved autologous bone marrow, and analyzed the results to determine the impact of timing of ABMT on treatment outcome. One (17 patients), two (24 patients), or three or more (29 patients) chemotherapy regimens had failed in patients before ABMT. results: The results for all 70 patients included a complete remission rate of 59%, an early death rate of 11%, a 4-year survival of 47%, and 27% of all treated patients alive and in complete remission at 4 years. The median follow-up for patients remaining in complete remission is 56 months (range 26 to 73 months). The frequency of achieving a complete remission was higher in patients in whom fewer regimens had failed before ABMT (i.e., 82% versus 58% versus 45%, p = 0.02), as was the 4-year disease-free survival (i.e., 44% versus 33% versus 21%, p = 0.04). conclusion: ABMT is a more effective therapy when used early for patients with relapsed Hodgkin's disease.

Original languageEnglish (US)
Pages (from-to)605-611
Number of pages7
JournalThe American journal of medicine
Volume91
Issue number6
DOIs
StatePublished - Dec 1991

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Autologous Transplantation
Bone Marrow Transplantation
Hodgkin Disease
Drug Therapy
Carmustine
Etoposide
Cyclophosphamide
Disease-Free Survival
Bone Marrow

ASJC Scopus subject areas

  • Medicine(all)

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Autologous bone marrow transplantation for patients with relapsed hodgkin's disease. / Armitage, James O.; Bierman, Philip J.; Vose, Julie M.; Anderson, James R.; Weisenburger, Dennis D.; Kessinger, Anne; Reed, Elizabeth C.; Vaughan, William P.; Coccia, Peter F.; Purtilo, David T.

In: The American journal of medicine, Vol. 91, No. 6, 12.1991, p. 605-611.

Research output: Contribution to journalArticle

Armitage, James O. ; Bierman, Philip J. ; Vose, Julie M. ; Anderson, James R. ; Weisenburger, Dennis D. ; Kessinger, Anne ; Reed, Elizabeth C. ; Vaughan, William P. ; Coccia, Peter F. ; Purtilo, David T. / Autologous bone marrow transplantation for patients with relapsed hodgkin's disease. In: The American journal of medicine. 1991 ; Vol. 91, No. 6. pp. 605-611.
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abstract = "purpose: High-dose therapy and autologous bone marrow transplantation (ABMT) are being increasingly utilized for the management of patients with relapsed Hodgkin's disease. Because patients with relapsed Hodgkin's disease often initially respond to salvage chemotherapy regimens, ABMT is frequently delayed until late in the course of the disease. The optimal timing for ABMT has not been identified. The purpose of this study was to determine the value of ABMT earlier in the course of Hodgkin's disease. patients and methods: We treated 70 patients between October 1984 and October 1988 with high-dose cyclophosphamide, carmustine, and etoposide, followed by infusion of previously cryopreserved autologous bone marrow, and analyzed the results to determine the impact of timing of ABMT on treatment outcome. One (17 patients), two (24 patients), or three or more (29 patients) chemotherapy regimens had failed in patients before ABMT. results: The results for all 70 patients included a complete remission rate of 59{\%}, an early death rate of 11{\%}, a 4-year survival of 47{\%}, and 27{\%} of all treated patients alive and in complete remission at 4 years. The median follow-up for patients remaining in complete remission is 56 months (range 26 to 73 months). The frequency of achieving a complete remission was higher in patients in whom fewer regimens had failed before ABMT (i.e., 82{\%} versus 58{\%} versus 45{\%}, p = 0.02), as was the 4-year disease-free survival (i.e., 44{\%} versus 33{\%} versus 21{\%}, p = 0.04). conclusion: ABMT is a more effective therapy when used early for patients with relapsed Hodgkin's disease.",
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AU - Bierman, Philip J.

AU - Vose, Julie M.

AU - Anderson, James R.

AU - Weisenburger, Dennis D.

AU - Kessinger, Anne

AU - Reed, Elizabeth C.

AU - Vaughan, William P.

AU - Coccia, Peter F.

AU - Purtilo, David T.

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N2 - purpose: High-dose therapy and autologous bone marrow transplantation (ABMT) are being increasingly utilized for the management of patients with relapsed Hodgkin's disease. Because patients with relapsed Hodgkin's disease often initially respond to salvage chemotherapy regimens, ABMT is frequently delayed until late in the course of the disease. The optimal timing for ABMT has not been identified. The purpose of this study was to determine the value of ABMT earlier in the course of Hodgkin's disease. patients and methods: We treated 70 patients between October 1984 and October 1988 with high-dose cyclophosphamide, carmustine, and etoposide, followed by infusion of previously cryopreserved autologous bone marrow, and analyzed the results to determine the impact of timing of ABMT on treatment outcome. One (17 patients), two (24 patients), or three or more (29 patients) chemotherapy regimens had failed in patients before ABMT. results: The results for all 70 patients included a complete remission rate of 59%, an early death rate of 11%, a 4-year survival of 47%, and 27% of all treated patients alive and in complete remission at 4 years. The median follow-up for patients remaining in complete remission is 56 months (range 26 to 73 months). The frequency of achieving a complete remission was higher in patients in whom fewer regimens had failed before ABMT (i.e., 82% versus 58% versus 45%, p = 0.02), as was the 4-year disease-free survival (i.e., 44% versus 33% versus 21%, p = 0.04). conclusion: ABMT is a more effective therapy when used early for patients with relapsed Hodgkin's disease.

AB - purpose: High-dose therapy and autologous bone marrow transplantation (ABMT) are being increasingly utilized for the management of patients with relapsed Hodgkin's disease. Because patients with relapsed Hodgkin's disease often initially respond to salvage chemotherapy regimens, ABMT is frequently delayed until late in the course of the disease. The optimal timing for ABMT has not been identified. The purpose of this study was to determine the value of ABMT earlier in the course of Hodgkin's disease. patients and methods: We treated 70 patients between October 1984 and October 1988 with high-dose cyclophosphamide, carmustine, and etoposide, followed by infusion of previously cryopreserved autologous bone marrow, and analyzed the results to determine the impact of timing of ABMT on treatment outcome. One (17 patients), two (24 patients), or three or more (29 patients) chemotherapy regimens had failed in patients before ABMT. results: The results for all 70 patients included a complete remission rate of 59%, an early death rate of 11%, a 4-year survival of 47%, and 27% of all treated patients alive and in complete remission at 4 years. The median follow-up for patients remaining in complete remission is 56 months (range 26 to 73 months). The frequency of achieving a complete remission was higher in patients in whom fewer regimens had failed before ABMT (i.e., 82% versus 58% versus 45%, p = 0.02), as was the 4-year disease-free survival (i.e., 44% versus 33% versus 21%, p = 0.04). conclusion: ABMT is a more effective therapy when used early for patients with relapsed Hodgkin's disease.

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