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Allogeneic peripheral blood stem cell transplantation following fludarabine-based conditioning in six children with advanced Hodgkin’s disease

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Abstract

Despite high-dose chemotherapy and autografting, the outcome for patients with primary refractory Hodgkin’s disease (HD) or multiple relapses remains unsatisfactory. Six pediatric patients (median age: 16 years, range: 11–19) received reduced intensity conditioning and allogeneic peripheral blood stem cell transplantation (PBSCT) after failure of stratified first-line chemotherapy, involved-field radiotherapy, and salvage chemotherapy including autologous PBSCT (two patients). For conditioning, fludarabine was combined with busulfan (8 or 12 mg/kg) and additional cyclophosphamide (three patients), or without cyclophosphamide (two patients), or melphalan (one patient). Two patients died of infections and one of progression. One patient remains in complete remission 59 months following transplantation. Two patients relapsed but responded after withdrawal of immunosuppression, chemotherapy, or donor lymphocyte infusions and are alive at 22 and 36 months post transplant, respectively. Allogeneic PBSCT, with reduced intensity conditioning, may be beneficial for selected patients with refractory HD.

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Authors and Affiliations

  1. Department of Pediatrics and Bone Marrow Transplant Unit, University of Kiel, Schwanenweg 20, 24105, Kiel, Germany

    Alexander Claviez

  2. Children’s Hospital III (Pediatric Hematology, Oncology and Hemostaseology), University Hospital Frankfurt, Frankfurt, Germany

    Thomas Klingebiel

  3. Bone Marrow Transplant Unit, University of Marburg, Marburg, Germany

    Jörg Beyer

  4. Division of Pediatrics, Clinic for Bone Marrow Transplantation, Idar Oberstein, Germany

    Wenzel Nürnberger

  5. Bone Marrow Transplantation Unit, University of Dresden, Dresden, Germany

    Gerhard Ehninger & Meinolf Suttorp

  6. Department of Hematology and Oncology, General Hospital St. Georg, Hamburg, Germany

    Peter Dreger & Norbert Schmitz

  7. 2nd Children’s Hospital, Helios Kinikum Berlin, Berlin-Buch, Germany

    Wolfgang Dörffel

Authors
  1. Alexander Claviez
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  2. Thomas Klingebiel
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  3. Jörg Beyer
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  4. Wenzel Nürnberger
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  5. Gerhard Ehninger
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  6. Meinolf Suttorp
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  7. Peter Dreger
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  8. Wolfgang Dörffel
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  9. Norbert Schmitz
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Correspondence to Alexander Claviez.

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Claviez, A., Klingebiel, T., Beyer, J. et al. Allogeneic peripheral blood stem cell transplantation following fludarabine-based conditioning in six children with advanced Hodgkin’s disease. Ann Hematol 83, 237–241 (2004). https://doi.org/10.1007/s00277-003-0814-y

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  • DOI: https://doi.org/10.1007/s00277-003-0814-y

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