HIGH-DOSE CHEMOTHERAPY FOLLOWED BY AUTOLOGOUS HEMATOPOIETIC RESCUE INHODGKINS-DISEASE - LONG-TERM FOLLOW-UP IN 128 PATIENTS

Background: There is little long term follow-up information after auto logous transplantation for Hodgkin's disease. We evaluated the influen ce of various prognostic factors and examined the outcome in 128 such patients. Patients and methods: Patients received high dose cyclophosp hamide, carmustine, and etoposide followed by autologous hematopoietic rescue. Results: Patients have been observed between 50-130 months (m edian 77 months) following transplantation. Overall survival at four y ears is estimated as 45 percent, and failure-free survival as 25 perce nt. The best results were seen in patients with a good performance sta tus, who had failed at most one prior chemotherapy regimen. Failure-fr ee survival at four years is estimated as 53 percent for this group. R elapses more than 24 months after transplantation were seen in 11 pati ents. Five patients developed myelodysplastic syndromes. Three patient s became pregnant after the transplant. Conclusions: Prolonged failure -free survival may be observed following high dose chemotherapy and au tologous hematopoietic rescue in patients with Hodgkin's disease. 'Sup erior results were seen in patients without extensive prior chemothera py and in those with a good performance status. Late relapses and deat hs from secondary myelodysplastic syndromes mandate prolonged follow-u p after autologous transplantation for Hodgkin's disease.