Autologous stem cell transplantation for advanced Hodgkin's disease in children

• Published in: Bone marrow transplantation (Basingstoke) Vol. 25; no. 1; pp. 31 - 34
• Main Authors: VERDEGUER, A, PARDO, N, DIAZ, M, SASTRE, A, MADERO, L, MARTINEZ, A, BUREO, E, FERNANDEZ, J. M, MUNOZ, A, OLIVE, T, FERNANDEZ-DELGADO, R, CUBELLS, J
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 2000
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antineoplastic agents; Biological and medical sciences; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Medical sciences; Pharmacology. Drug treatments; Stem cell transplantation; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Human; Antineoplastic agent; Prognosis; Stem cell; Hematopoietic cell; Hodgkin disease; Malignant hemopathy; Radiotherapy; Lymphoma; Blood; Autograft; Chemotherapy; Treatment; Lymphoproliferative syndrome; Bone marrow; Graft; Myelosuppression; Advanced stage; Combined treatment; Child
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1702094

This study evaluates the outcome of myeloablative chemo-radiotherapy and autologous stem cell transplantation (ASCT) in children with Hodgkin's disease (HD). Twenty children aged 5 to 18 years (median 10.8 years) at diagnosis, with relapsed, refractory or very poor prognosis HD, underwent ASCT in eight hospitals of our country. Status at transplant was: second complete remission (CR2): n = 12; further CR (CR >2): n = 3, partial remission (PR): n = 2, relapse: n = 2 and first CR (CR1): n = 1. Eighteen patients received chemotherapy-based conditioning regimens: cyclophosphamide, carmustine and etoposide (CBV): 11 (55%), carmustine, etoposide, cytarabine and melphalan (BEAM): 5, other: 2; and two patients were conditioned with TBI/Cy. Peripheral blood (PB) was the source of progenitor cells in 12 patients, BM in seven, and BM plus PB, in one. All patients engrafted. One patient died of sepsis and multiorgan failure at day 28 after transplantation. All four patients with measurable disease (PR or relapse) at transplantation attained complete remission. Five patients relapsed 5-34 months after transplant (median: 11 months). Eighteen children remain alive with a median survival time of 40 months. The projected 5-year overall survival and event-free survival (EFS) rates were 0.95 and 0.62. High-dose therapy with stem cell rescue can lead to durable remissions in children with advanced HD. Bone Marrow Transplantation (2000) 25, 31-34.