Hematologic toxic reaction to radiation therapy adjuvant to autologous peripheral blood stem cell transplantation for recurrent or refractory Hodgkindisease

PURPOSE: To evaluate the hematologic toxic reaction to external-beam radiat ion therapy after high-dose chemotherapy with peripheral blood stem cell (P BSC) support in patients with Hodgkin disease. MATERIALS AND METHODS : A retrospective study of 30 cases of Hodgkin diseas e in patients who underwent high-dose carmustine, etoposide, and cyclophosp hamide chemotherapy with PBSC support was performed. Thirteen patients unde rwent radiation therapy (28.&39.0 Cy) a median of 45 days after PBSC repeat infusion. RESULTS: Radiation therapy was delivered as planned, without interruption, in all patients. Five patients developed thrombocytopenia tone with grade 1 thrombocytopenia; two, grade 2; and two, grade 3) and included three with progressive disease prior to radiation therapy and two with a history of pr ior irradiation. None developed a bleeding complication or required transfu sion support. Five patients who underwent irradiation had thrombocytopenia (three with grade 1 and two with grade 2) 100 days after PBSC repeat infusi on, compared with three patients (two with grade 1 and one with grade 3) wh o did not undergo posttransplantation irradiation. At the most recent follo w-up, no patient without evidence of disease had a platelet count of less t han 100 x 10(9)/L. CONCLUSION: External-beam radiation therapy was well tolerated in the postt ransplantation setting in patients with Hodgkin disease. Thrombocytopenia w as common but was not related to clinical complications.