PROGRESSIVE DISEASE AFTER ABMT FOR HODGKINS-DISEASE

A major limitation of ABMT for relapsed/refractory Hodgkin's disease i s disease recurrence post-transplantation. We retrospectively reviewed 68 patients undergoing ABMT from January 1987 to June 1993. All recei ved a uniform preparatory regimen (CBV), The median patient age was 30 ; 75% received prior radiation therapy and all patients received prior chemotherapy, Thirty-one percent presented at the time of transplanta tion with tumor masses larger than 10 cm, Sixty-two percent received a utologous marrow alone and 38% PBPC with or without autologous bone ma rrow, Overall and progression-free survival are 43 and 36% at 5 years, Median follow-up for survivors is 59 months, Multivariate analysis re vealed that tumor bulk was the most powerful poor prognostic factor fo r both survival and progression-free survival, Those transplanted with non-bulky tumors had an overall survival and progression-free surviva l of 52 and 44%, respectively, compared to those transplanted with bul ky tumors who had an overall survival and progression-free survival of 22 and 16% (P = 0.03 and P = 0.04, respectively), Twenty-seven patien ts have relapsed, Four relapsed more than 2 years after ABMT, Four of the 27 patients who have relapsed remain alive, two without evidence o f disease, The time after transplant to relapse was prognostically imp ortant, with no patients who relapsed within 6 months of ABMT still be ing alive, compared with 25% of patients who relapsed 7 or more months after ABMT who are still alive, We conclude that salvage therapy for relapse after ABMT is appropriate, as some patients may achieve prolon ged survival. The time from transplant to relapse is an important surv ival predictor.