Abstract
Table 1 summarizes the results of autologous bone marrow transplantation (ABMT) in more than 200 patients. The results seem to be rather consistent between the groups who have the largest published series of ABMT in Hodgkin’s lymphoma. These results can be summarized as follows: about half of the patients not responding to primary induction chemotherapy or refractory to two or more chemotherapy regimens can obtain complete remission by high-dose chemotherapy and ABMT, and about half of the complete responders can be expected to remain in long-term disease-free survival. Even though toxicity and morbidity of this aggressive procedure are high, the death rate is about 10%. Thus, there is no doubt that high-dose chemotherapy with ABMT is an established approach in certain patients with Hodgkin’s disease. However, as this approach is very toxic, several questions arise: what are the characteristics of patients with Hodgkin’s disease who are likely to profit from this approach; which is the optimal high-dose myeloablative regimen; which is the optimal source of stem cells for hematopoietic reconstitution; is there any value in bone marrow purging; how can toxicity be reduced; and what are the future prospects of ABMT in Hodgkin’s lymphoma?
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Ahmed T, Gingrich SA, Ciavarella D et al. (1987) Myeloablative chemotherapy followed by autologous bone marrow transplantation ( ABMT) for patients with refractory Hodgkin’s disease. Proc Am Soc Hematol 23: 239
Antmann K, Griffin J, Elias A, Socinski M, Whitley M, Ryan L, Cannutra S, Frei E, Schnipper L (1988) Effect of rGM-CSF on chemotherapy induced myelosuppression in sarcoma patients. Proc ASCO 7: 619
Appelbaum FR, Sullivan KM, Thomas ED, Buckner CD, Clift RA, Deeg HJ, Neiman PE, Sanders JE, Stewart P, Storb R (1985) Allogeneic Marrow Transplantation in the Treatment of MOPP Resistant Hodgkin’s Disease. J Clin Oncol 3: 1490–1494
Brandt SJ, Peters WP, Atwater SK, Kurtzberg J, Borowitz MJ, Jones RB, Shpall EJ, Bast RC, Gilbert CJ, Oette DH (1988) Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation. N Engl J Med 318: 869–876
Carella AM, Santini G, Santoro A et al. (1985) Massive chemotherapy with non-frozen autologous bone marrow transplantation in 13 cases of refractory Hodgkin’s disease. Eur J Cancer Clin Oncol 21: 607–613
Carella AM, Congiu A, Santini G et al. (1986) High dose chemotherapy (HDC) and autologous bone marrow transplantation in advanced highly treated Hodgkin’s disease ( AHTHD ). Bone Marrow Transplant 1: 293–296
Carella AM, Congiu A, Santini G et al. (1987) High-dose cyclophosphamide, etoposide and BCNU with autologous BMT (ABMT) rescue in advanced resistant Hodgkin’s disease patients. Bone Marrow Transplant 2 [Suppl 1]: 210
Carella AM, Congiu A, Mazza P et al. (1988) High-dose chemotherapy with autologous BMT “rescue” in 50 advanced resistant Hodgkin’s disease patients. An Italian Study Group Report. J Clin Oncol 6: 1411–1416
Gribben JG, Goldstone AH (1987) Bone marrow transplantation in NHL and Hodgkin’s lymphoma in remission-autologous versus allogeneic. Bone Marrow Transpl 2: 204
Gribben JG, Vaughan Hudson B, Linch DC (1987a) The potential value of very intensive therapy with autologous bone marrow rescue in the treatment of malignant lymphomas. Hemat Oncol 5: 281–293
Gribben JG, Goldstone AH, Linch DC, Anderson CC, Richards JDM (1987b) Double autografting as potential curative therapy for acute leukaemia. Bone Marrow Transplant 2: 46–48
Jagannath S, Dicke KA, Armitage JO, Cabanillas F, Horwitz LJ, Vellekoop L, Zander AR, Spitzer G (1986) High dose cyclophosphamide, carmustine and etoposide and autologous bone marrow transplantation for relapsed Hodgkin’s disease. Ann Intern Med 1024: 4163–4168
Jagannath S, Armitage JO, Spitzer G et al. (1986b) Prognostic factors predicting for response to high dose chemotherapy and autologous bone marrow transplantation ( ABMT) for relapsed Hodgkin’s disease. Blood 68: 274
Kessinger A, Armitage JO, Landmort JD et al. (1986) Cryopreserved autologous peripheral stem cell infusions following high-dose therapy result in complete restoration of hematologic function for patients with non-leukemic malignancies. Am Soc Hematol 68: 290
Loeffler M, Pfreundschuh M, Hasenclever D et al. (1988) Prognostic risk factors in advanced Hodgkin’s lymphoma. Blut 56: 273–281
Maclntyre EA (1986) The use of monoclonal antibodies for purging autologous bone marrow in the lymphoid malignancies. In: Goldstone AH (ed) Clinics in haematology. Saunders, London, pp 249–267
Maseret B, Maraninchi D, Gastaut A et al. (1986) Treatment of malignant lymphoma with high-dose of chemo-or chemoradiotherapy and bone marrow transplantation. Eur J Cancer Clin Oncol 3: 461–471
Nadler LM, Takvorian T, Botwick L, Bast RC, Finberg R, Hellman S, Canellos GP, Schloss-man SF (1984) Anti B1 monoclonal antibodies and complement treatment in autologous bone marrow transplantation for relapsed B cell non-Hodgkin’s lymphoma. Lancet 25 (2): 427–431
O’Reilly S, Connors J, Voss N et al. (1987) High-dose cyclophosphamide, BCNU and etoposide (CVB) and autologous bone marrow transplantation in progressive Hodgkin’s disease ( HD ). Proc ASCO 23: 196
Pfreundschuh M, Mommertz E, Meissner M, Feller AC, Hassa R, Krüger GR, Diehl V (1988) Hodgkin and Reed-Sternberg cell associated monoclonal antibodies HRS-1 and HRS-2 react with activated cells of lymphoid and monicytoid origin. Anticancer Res 8: 217–224
Philip T, Dumont J, Teillet F, Maraninchi D et al. (1986) High dose chemotherapy and autologous bone marrow transplantation in refractory Hodgkin’s disease. Br J Cancer 53: 737–742
Phillips G, Barnett M, Buskard N et al. (1986) Augmented cyclophosphamide (C), BCNU (B) and etoposide (V) = CVB and autologous bone marrow transplantation ( BMT ). Blood 68: 277
Spitzer G, Dicke KA, Litam J et al. (1980) High dose combination chemotherapy with autologous bone marrow transplantation in adult solid tumors. Cancer 45: 3075–3085
Sullivan KM, Appelbaum FR, Horning SJ, Rosenberg SA, Thomas ED (1986) Selection of patients with Hodgkin’s disease and non-Hodgkin’s lymphoma for bone marrow transplantation. Int J Cell Cloning 4: 94–106
Teillet F, Pulik M, Teillet-Thieband F et al. (1987) Autologous bone marrow transplantation ( ABMT) in poor prognosis Hodgkin’s disease. Bone Marrow Transplant 2: 211
Vaughan Hudson B, Maclennan KA, Easterling M.1, Jellife AM, Haybittle JL, Vaughan Hudson G (1983) The prognostic significance of age in Hodgkin’s disease: examination of 1500 patients. Clin Radiol 34: 503–506
Yeager AM, Kaizer H, Santos GW et al. (1986) Autologous bone marrow transplantation in patients with acute non-lymphocytic leukemia using ex vivo treatment with 4-hydroperoxycyclophosphamide. New Engl J Med 315: 141
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1989 Springer-Verlag Berlin · Heidelberg
About this paper
Cite this paper
Armitage, J.O. et al. (1989). Bone Marrow Transplantation in the Treatment of Hodgkin’s Lymphoma: Problems, Remaining Challenges, and Future Prospects. In: Diehl, V., Pfreundschuh, M., Loeffler, M. (eds) New Aspects in the Diagnosis and Treatment of Hodgkin’s Disease. Recent Results in Cancer Research, vol 117. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83781-4_28
Download citation
DOI: https://doi.org/10.1007/978-3-642-83781-4_28
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-83783-8
Online ISBN: 978-3-642-83781-4
eBook Packages: Springer Book Archive