VI Autologous Bone Marrow Transplantation.pdf - Blog Science ...

more than 80% of the cases. Patients receiving the higher etoposide dose on average
developed grade 3-4 mucositis, and those receiving the lower dose developed
grade 2 mucositis. No patient developed clinically apparent cardiac toxicity.
DISCUSSION
High dose chemotherapy with hematopoietic stem cell support has changed
the outlook for patients with progressive HD. However, the prognosis remains
bleak for patients whose disease never responded to conventional therapy or
who suffer a recurrence that is chemotherapy resistant ( 3
). Likewise, patients
with recurrent disease after a previous autologous transplant have mostly been
subjected to palliative measures. The MVT regimen was introduced to explore
the possibility of disease control in this "poor-prognosis" patient population at
the potential price of higher treatment-related morbidity/mortality. We consider
the response rate of 47% very encouraging, comparing favorably to results with
CBV at our institution ( 3
), and to that obtained with more intensive autologous
transplant regimens at other centers ( 1516
). Although 2 CR patients died from
complications, another 6 were still progression-free, five of whom had been followed
15+ months. One additional patient who achieved a clinical CR lasting 9
months subsequently had recurrence in abdominal lymph nodes. He was given
local consolidation radiotherapy and remained in an extended clinical CR for 9+
months following radiation.
The overall survival and the progression-free survival of our patients compare
favorably to a historical group that had induction-refractory HD, or disease
that recurred after a short (