R. Little et al., VINBLASTINE FOR RECURRENT HODGKINS-DISEASE FOLLOWING AUTOLOGOUS BONE-MARROW TRANSPLANT, Journal of clinical oncology, 16(2), 1998, pp. 584-588
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.