VINBLASTINE FOR RECURRENT HODGKINS-DISEASE FOLLOWING AUTOLOGOUS BONE-MARROW TRANSPLANT

Citation
R. Little et al., VINBLASTINE FOR RECURRENT HODGKINS-DISEASE FOLLOWING AUTOLOGOUS BONE-MARROW TRANSPLANT, Journal of clinical oncology, 16(2), 1998, pp. 584-588
Citations number
26
Categorie Soggetti
Oncology
ISSN journal
0732183X
Volume
16
Issue
2
Year of publication
1998
Pages
584 - 588
Database
ISI
SICI code
0732-183X(1998)16:2<584:VFRHFA>2.0.ZU;2-B
Abstract
Purpose: Bone marrow transplant (BMT) can cure recurrent Hodgkin's dis ease, but more than half of patients will progress and require additio nal treatment. When this occurs, there are no curative options and pal liative therapy is usually indicated. In such patients, we have routin ely used long-term vinblastine therapy because of its relatively low t oxicity and high activity. Patients and Methods: We retrospectively re viewed the charts of all patients with Hodgkin's disease who relapsed after autologous BMT since 1991. Of 23 patients, 16 received vinblasti ne; we also include our index case, who began vinblastine following re lapse in 1987. Patients received vinblastine 4 to 6 mg/m(2) every 1 to 2 weeks, and continued until evidence of disease progression. Results : The 17 patients in this report herd a median age of 31 years, perfor mance status of 2, had received a median of three prior regimens, and 12 (71%) patients were advanced stage. Ten (59%) patients had objectiv e responses, of which two (12%) were complete (CR) and eight (47%) wer e partial (PR). Two additional patients without measurable disease cli nically improved for more than 6 months, and 1 patient had stable dise ase for more than 18 months. With a median follow-up of 20.4 months, t he median event-free (EFS) and overall survival were 8.3 and 38.8 mont hs, respectively. The two complete responders remain in remission at 4 .6+ and 9+ years. Vinblastine was well tolerated with 3% of cycles ass ociated with fever and neutropenia, and no cumulative or chronic toxic ity. Conclusion: Vinblastine provides effective palliation with low to xicity in recurrent Hodgkin's disease following transplant. These resu lts suggest that long-term vinblastine therapy may be potentially cura tive and should be considered as initial therapy for such patients. (C ) 1998 by American Society of Clinical Oncology.