Allogeneic BMT May Be Optimal for Refractory Hodgkin's Lymphoma
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NEW YORK (Reuters Health) Dec 11 - Hodgkin's lymphoma patients who undergo allogeneic blood and marrow transplantation (BMT) are less likely to experience a relapse than are patients who undergo autologous BMT, according to a recent report.
In addition, allogeneic BMT seems to be tied to a lower risk of secondary blood dyscrasias than autologous BMT, researchers note in the December 1st issue of the Journal of Clinical Oncology.
Allogeneic BMT is generally considered preferable to autologous BMT for the treatment of leukemias. However, the optimal type of BMT for patients with Hodgkin's lymphoma has remained unclear.
Dr. Richard J. Jones, from Johns Hopkins Oncology Center in Baltimore, and colleagues assessed the outcomes of 157 patients with relapsed or refractory Hodgkin's disease who underwent BMT between March 1985 and April 1998. Of these patients, 53 underwent allogeneic BMT and 104 underwent autologous BMT. The median follow-up period for surviving patients was 5.1 years.
The 10-year probabilities of event-free survival and relapse for the entire group were 26% and 58%, respectively. Disease status before BMT independently influenced event-free survival and relapse, whereas date of BMT influenced only the event-free survival.
In treatment-sensitive patients, the risk of relapse was two-fold higher for autologous BMT patients than for allogeneic BMT patients. No cases of relapse or secondary acute myeloid leukemia/myelodysplastic syndrome were noted in the allogeneic BMT group at 3 years after treatment. In the autologous group, however, relapses or secondary disease was still reported up to 12 years after BMT.
The current findings suggest that allogeneic BMT is tied to a clinical graft-versus-Hodgkin's lymphoma effect, the authors state. Previous reports have described disappointing allogeneic BMT results, but the patients selected may have been poor transplantation candidates, the researchers postulate.
Based on the current results, allogeneic BMT warrants further study in Hodgkin's disease patients.
J Clin Oncol 2001;19:4314-4321. |
