Long-term Outcome of Hodgkin Disease Patients Following High-Dose Busulfan, Etoposide, Cyclophosphamide, and Autologous Stem Cell Transplantation

Navin Wadehra, Sherif Farag, Brian Bolwell, Patrick Elder, Sam Penza, Matt Kalaycio, Belinda Avalos, Brad Pohlman, Guido Marcucci, Ronald Sobecks, Thomas Lin, Steven Andrèsen, Edward Copelan

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Busulfan (Bu)-based preparative regimens have not been extensively investigated in Hodgkin disease (HD). The purposes of this study were to investigate the toxicity and efficacy of a novel preparative regimen of Bu 14 mg/kg, etoposide 50-60 mg/kg, and cyclophosphamide 120 mg/kg in patients with primary refractory and relapsed HD. One hundred twenty-seven patients with a median age of 33 years (range, 14-67 years) underwent transplantation. The regimen was well tolerated, with 5.5% treatment-related mortality at 100 days after transplantation. With a median follow up of 6.7 years, the 5-year progression-free survival was 48 ± 5%, and the 5-year overall survival was 51 ± 5%. A Cox proportional hazards model identified refractory disease at time of transplantation as the only significant factor affecting relapse and overall survival, whereas disease bulk >10 cm affected overall survival. Five patients died between 5.3 and 9.3 years of late complications, including secondary myelodysplasia or acute myeloid leukemia, secondary solid malignancies, and pulmonary toxicity. This novel Bu regimen is comparable to other radiation-free preparative regimens in its effectiveness in the control of HD and with a low-risk of early treatment-related mortality.

Original languageEnglish (US)
Pages (from-to)1343-1349
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume12
Issue number12
DOIs
StatePublished - Dec 1 2006

Keywords

  • Autotransplant
  • Busulfan
  • Hodgkin's disease

ASJC Scopus subject areas

  • Transplantation

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