Autologous stem cell transplantation for advanced Hodgkin's disease in children

This study evaluates the outcome of myeloablative chemo-radiotherapy and au tologous stem cell transplantation (ASCT) in children with Hodgkin's diseas e (HD), Twenty children aged 5 to 18 years (median 10.8 years) at diagnosis , with relapsed, refractory or very poor prognosis HD, underwent ASCT in ei ght hospitals of our country. Status at transplant was: second complete rem ission (CR2): n = 12; further CR (CR >2): n = 3, partial remission (PR): n = 2, relapse: n = 2 and first CR (CR1): n = 1, Eighteen patients received c hemotherapy-based conditioning regimens: cyclophosphamide, carmustine and e toposide (CBV): 11 (55%), carmustine, etoposide, cytarabine and melphalan ( BEAM): 5, other: 2; and two patients were conditioned with TBI/Cy, Peripher al blood (PB) was the source of progenitor cells in 12 patients, BM in seve n, and BM plus PB, in one. All patients engrafted, One patient died of seps is and multiorgan failure at day 28 after transplantation, All four patient s with measurable disease (PR or relapse) at transplantation attained compl ete remission. Five patients relapsed 5-34 months after transplant (median: 11 months). Eighteen children remain alive with a median survival time of 40 months. The projected 5-year overall survival and event-free survival (E FS) rates were 0.95 and 0.62. High-dose therapy with stem cell rescue can l ead to durable remissions in children with advanced HD.