Prognostic factors for survival after high-dose therapy and autologous stem cell transplantation for patients with relapsing Hodgkin's disease: Analysis of 280 patients from the French registry
Prognostic factors for survival after high-dose therapy and autologous stem cell transplantation for patients with relapsing Hodgkin's disease: Analysis of 280 patients from the French registry
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DOI：
10.1038/sj.bmt.1700838
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发表时间：
1997-07-01
影响因子：
4.8
通讯作者：
Colombat, P
中科院分区：
文献类型：
--
作者：
Brice, P;Bouabdallah, R;Colombat, P
大剂量自体造血干细胞移植（ASCT）治疗复发性霍奇金病（HD）已被广泛提出，从1982年至1993年，我们选择了（来自法国骨髓移植登记处）280例患者，在初始治疗（包括化疗）后接受ASCT治疗复发性HD，诊断时患者特征为：性别比（M/F）：1.5;年龄中位数：30岁（5-59岁），I、II期：43%; III、IV期：57%; 32%接受化疗，68%接受化疗+放疗，所有患者在一线治疗后均达到完全缓解，随后复发，诊断和大剂量治疗之间的中位间隔时间为34个月，78%的患者首次复发，治疗结束至复发的中位时间为18个月，所有患者在大剂量治疗前均接受了挽救化疗，复发与大剂量治疗之间的中位时间为5个月。84%的患者被认为具有化学敏感性复发，预处理方案为：BEAM：60%; CBV/BEAC：26%，移植相关死亡率为6%，大剂量治疗后中位随访3年，4年总生存率和无进展生存率分别为66%和60%，影响生存率的因素有：复发的化疗敏感性（P < 0.001）和首次复发与再次复发（P < 0.05）。214例首次复发患者中，其他影响生存率的因素有：治疗结束至复发间隔时间
High-dose therapy with autologous stem cell transplantation (ASCT) has been widely proposed for patients with relapsed Hodgkin's disease (HD), From 1982 to 1993, we selected (from the French registry for bone marrow transplantation) 280 patients, who underwent ASCT for relapsed HD after initial treatment including chemotherapy, Patient characteristics at diagnosis were: sex ratio (M/F): 1.5; median age: 30 years (5-59 years), stage I, II: 43%; III, IV: 57%; 32% had chemotherapy, 68% chemo+ radiotherapy, All patients achieved complete remission after first-line therapy and subsequently relapsed, The median interval between diagnosis and high-dose therapy was 34 months, First relapse occurred in 78% of the patients at a median end-of-treatment to relapse time of 18 months, All patients received salvage chemotherapy before high-dose therapy, and the median time between relapse and high-dose therapy was 5 months, After this regimen, 84% of the patients were considered to have chemosensitive relapse, Conditioning regimens were: BEAM: 60%; CBV/BEAC: 26%, Transplant-related mortality was 6%, With a median follow-up of 3 years after high-dose therapy, overall and progression-free survivals at 4 years were, 66 and 60%, respectively, Neither the conditioning regimen nor the stem cell source affected survival, Good prognostic factors for survival were: chemosensitivity of relapse (P < 0.001) and first relapse vs further relapse (P < 0.05), For 214 patients in first relapse, other significant factors for survival were: end-of-treatment to relapse interval