Medline: 10071273

The abstract Journal of Clinical Oncology 17(3): 825-831, 1999. is available online.

The fulltext Journal of Clinical Oncology 17(3): 825-831, 1999. may be available online for subscribers.

Autologous hematopoietic stem-cell transplantation for relapsed or refractory Hodgkin's disease in children and adolescents.

Baker KS, Gordon BG, Gross TG, et al.

Abstract:

Purpose:
To determine the treatment outcome and clinical factors that are of prognostic significance for children and adolescents with relapsed or refractory Hodgkin's disease (HD) who received treatment with high-dose chemotherapy and autologous hematopoietic stem-cell transplantation (HSCT).

Patients and Methods:
Fifty-three consecutive children and adolescents 21 years of age or younger with relapsed or refractory HD underwent HSCT.

Results:
At day 100 after transplantation, 29 patients (55%) were in a complete remission or maintained a continuous complete response, six (11%) had a partial response, and 11 (21%) failed to respond or had progressive disease. The failure-free survival (FFS) at 5 years was 31%, and overall survival was 43%. Twenty-one patients died of progressive HD, and nine died secondary to transplantation-related complications, including two secondary leukemias. Prognostic factors important for FFS were normal pretransplantation lactate dehydrogenase levels (5-year FFS = 42%), compared with patients with elevated LDH levels (5-year FFS = 0%) (P < .001), and disease sensitivity at the time of HSCT with FFS in untreated relapse, sensitive disease, and resistant disease 44%, 35%, and 9%, respectively (P = .06). There was no statistically significant difference in FFS or overall survival between age subgroups that were analyzed (< 13, 13 to 18, 19 to 21) or in comparison with an adult cohort.

Conclusion:
HSCT is an effective treatment modality that can result in long-term cures and should be considered for children and adolescents with relapsed HD.


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