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Autografting

Front-line high-dose therapy with autologous stem cell transplantation for high risk Hodgkin's disease: comparison with combined-modality therapy

Bone Marrow Transplantation volume 29, pages 833–842 (2002)Cite this article

Abstract

This retrospective study compares high-dose therapy (HDT) with autologous stem cell transplantation and combined-modality treatment (CT) as a first-line therapy for Hodgkin's disease (HD) for patients with both a clinical stage (CS) IV and/or a mediastinal mass ⩾0.45 of the thoracic diameter (MM ⩾0.45) at diagnosis, and an incomplete response after the first-line chemotherapy. Data on 42 grafted patients (GP) in Nantes Hospital, France and on 108 combined-modality treated patients (CTP) from two protocols of the GOELAMS group, France (POF 81 and H90) was analyzed. Both groups were comparable except for pulmonary disease in excess in the grafted group (P = 0.01). Among GP, 95% were in complete response at the end of first-line treatment and 77% among CTP. Median follow-up was 53 months (range, 7 to 128 months) for GP and 88 months (range, 25 to 181 months) for CTP. The 5-year freedom from progression (FFP) and event-free survival (EFS) rates were better for GP (87% vs 55% for FFP: P = 0.0004 and 81% vs 51% for EFS: P = 0.0004) whereas the overall survival (OS) rates did not differ significantly (85% for GP vs 71% for CTP: P = 0.06). Similar results were obtained for the groups with a response ⩾50% after initial chemotherapy: 91% vs 65% for FFP, P = 0.01; 87% vs 61% for EFS, P = 0.02; and 92% vs 77% for OS, P = 0.2; and for the groups with a response <50%: 80% vs 22% for FFP, P = 0.0003; 72% vs 13% for EFS, P = 0.0001; and 76% vs 46% for OS, P = 0.04. This study shows a better control of the disease with HDT.

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Acknowledgements

We are indebted to the GOELAMS group, France for facilitating our access to the necessary data, and we thank Brigitte Gueglio for her skillfull assistance and Martin Pule for reviewing the manuscript.

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Authors and Affiliations

  1. University Hospital, Nantes, France

    S Vigouroux, N Milpied, P Moreau, F Mechinaud, B Mahe, N Morineau, M Vigier, MJ Rapp & JL Harousseau

  2. Hopital Europeen G Pompidou, Paris, France

    JM Andrieu & P Colonna

  3. University Hospital, Angers, France

    N Ifrah

  4. University Hospital, Tours, France

    P Colombat

  5. University Hospital, Amiens, France

    B Desablens

  6. University Hospital, Brest, France

    JF Abgrall

  7. University Hospital, Bobigny, France

    P Casassus

  8. University Hospital, Poitiers, France

    F Guilhot

  9. Hopital Beaujon, Paris, France

    J Briere

  10. Centre anti-cancereux Rene Gauducheau, Nantes, France

    A Le Mevel

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Vigouroux, S., Milpied, N., Andrieu, J. et al. Front-line high-dose therapy with autologous stem cell transplantation for high risk Hodgkin's disease: comparison with combined-modality therapy. Bone Marrow Transplant 29, 833–842 (2002). https://doi.org/10.1038/sj.bmt.1703547

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