Tandem Autologous Hematopoietic Cell Transplantation for Patients with Primary Progressive or Recurrent Hodgkin Lymphoma: A SWOG and Blood and Marrow Transplant Clinical Trials Network Phase II Trial (SWOG S0410/BMT CTN 0703) Journal Article

Local Library Link: Find It @ Loyola

Authors: Smith, E. P.; Li, H; Friedberg, J. W.; Constine, L. S.; Rimsza, L. M.; Cook, J. R.; Laport, G. G.; Popplewell, L. L.; Holmberg, L. A.; Smith, S. M.; LeBlanc, M; Forman, S. J.; Fisher, R. I.; Stiff, P. J.
Article Title: Tandem Autologous Hematopoietic Cell Transplantation for Patients with Primary Progressive or Recurrent Hodgkin Lymphoma: A SWOG and Blood and Marrow Transplant Clinical Trials Network Phase II Trial (SWOG S0410/BMT CTN 0703)
Abstract: Based on promising pilot data a phase II tandem autologous hematopoietic stem cell transplant (AHSCT) trial for relapsed/refractory Hodgkin lymphoma (HL) was performed in the US intergroup setting to determine if long-term progression-free survival (PFS) could be improved. Patients were enrolled after salvage therapy and stem cell collection. Sensitivity to salvage was defined by 1999 Standardized Response Criteria and did not include fluorodeoxyglucose-positron emission tomography. Cycle 1 consisted of melphalan 150 mg/m(2) with half of the stem cells. For stable disease or better, patients received cycle 2 consisting of single doses of etoposide 60 mg/kg and cyclophosphamide 100 mg/kg and either total body radiation 12 Gy in 8 fractions over 4 days or BCNU 150 mg/m(2)/day for 3 days with the remaining stem cells. Of 98 enrolled patients, 89 were eligible and treated: 82 completed both cycles of AHSCT, 47 (53%) had primary refractory HL, and 72 (81%) were resistant to salvage therapy. There were no treatment-related deaths in the first year after AHSCT. With a median follow-up of 6.2 years (range, 2 to 7.7) for eligible patients who remained alive, the 2-year and 5-year PFS were 63% (95% CI, 52% to 72%) and 55% (95% CI, 44% to 64%) respectively; the 2-year and 5-year overall survival were 91% (95% CI, 83% to 95%) and 84% (95% CI, 74% to 90%), respectively. Univariate Cox regression analysis showed Zubrod performance status and lactate dehydrogenase levels gt; 1 times upper limit of normal at the time of enrollment were significantly associated with PFS. The observed 5-year PFS of 55% suggests the tandem approach appears to be effective in treating HL patients demonstrated to have poor prognosis in prior single AHSCT trials. This trial was registered at www.clinicaltrials.gov as NCT00233987.
Journal Title: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Volume: 24
Issue: 4
ISSN: 1523-6536; 1083-8791
Publisher: The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc  
Journal Place: United States
Date Published: 2018
Start Page: 700
End Page: 707
Language: eng
DOI/URL:

S1083-8791(17)31830-X
Notes: LR: 20180416; CI: Copyright (c) 2017; ClinicalTrials.gov/NCT00233987; GR: U10 CA180888/CA/NCI NIH HHS/United States; GR: U10 HL069294/HL/NHLBI NIH HHS/United States; JID: 9600628; OTO: NOTNLM; 2017/04/06 00:00 [received]; 2017/12/21 00:00 [accepted]; 2018/01/01 06:00 [pubmed]; 2018/01/01 06:00 [medline]; 2018/01/01 06:00 [entrez]; ppublish