BONE-MARROW TRANSPLANTS FROM HLA-IDENTICAL SIBLINGS IN ADVANCED HODGKINS-DISEASE

Purpose: To determine the outcome of HLA-identical sibling marrow tran splants in advanced Hodgkin's disease. Patients and Methods: We review ed the data on 100 consecutive patients with Hodgkin's disease who rec eived HLA-identical sibling bone marrow transplants between April 1, 1 982 and August 12, 1992, reported to the International Bone Marrow Tra nsplant Registry (IBMTR). The median interval from diagnosis to transp lant was 2.5 years (range, < 1 to 14). All had advanced disease. Eight y-nine of 100 patients were not in remission at the time of transplant . Fifty had pretransplant Karnofsky scores less than 90% and 27 had ac tive infection in the week before transplant. Patients received a vari ety of conditioning regimens; 45 received total-body radiation. Result s: The 100-day probability of acute graft-versus-host disease (GVHD) w as 35% (95% confidence interval [Cl], 26% to 46%); the 3-year probabil ity of chronic GVHD was 45% (95% Cl, 31% to 59%). The 3-year probabili ty of relapse was 65% (95% CI, 50% to 78%). The 3-year probability of survival was 21% (95% Cl, 14% to 30%). The 8-year disease-free surviva l rate was 15% (95% Cl, 9% to 24%). Conclusion: HLA-identical sibling bonemarrow transplants have a limited role in advanced Hodgkin's disea se. (C) 1996 by American Society of Clinical Oncology.