SINGLE AND DOUBLE AUTOTRANSPLANTS FOR RELAPSING REFRACTORY HODGKINS-DISEASE - RESULTS OF 2 CONSECUTIVE TRIALS/

To evaluate a strategy of one cycle of dose-intensive chemotherapy for patients with Hodgkin's disease in sensitive relapse and two cycles f or those with refractory disease, 122 patients received dose-intensive chemotherapy followed by autotransplant in two consecutive studies, P atients with refractory disease were offered a second transplant with different conditioning in the absence of progression or excessive toxi city, CR was present after treatment in 46% while 16% died in the peri transplant period, Of 41 patients with primary refractory disease and 42 with refractory relapse, 24 and 21 respectively received a second c ycle, Of these 45 refractory patients, 12 were in CR and 11 in PR afte r the first cycle and 10 of these 11 in PR achieved a durable CR with the second transplant, The CR rate is 37% in patients with refractory relapse and 19% in those with primary refractory disease, At a median follow-up of 4 years, median survival is 45 months, Progression-free s urvival of the refractory patients who could receive a second cycle wa s similar to that of patients with sensitive disease, A sequential tra nsplant strategy is feasible, A subgroup of patients with refractory d isease can achieve long-term survival after sequential BMT.