ESHAP is an active regimen for relapsing Hodgkin's disease

被引:91
作者
Aparicio, J [1 ]
Segura, A [1 ]
Garcerá, S [1 ]
Oltra, A [1 ]
Santaballa, A [1 ]
Yuste, A [1 ]
Pastor, M [1 ]
机构
[1] Hosp Univ La Fe, Med Oncol Serv, Dept Med Oncol, E-46009 Valencia, Spain
关键词
Hodgkin's disease; relapse; salvage chemotherapy;
D O I
10.1023/A:1026454831340
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Refractory or relapsing Hodgkin's disease is associated with a poor prognosis. There is no widely accepted salvage chemotherapy regimen for these patients. However, the addition of high-dose chemotherapy followed by autologous hematopoietic transplantation (AHT) has proven of benefit to them. A prospective clinical trial was carried out to evaluate the efficacy and toxicity of ESHAP (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin). Patients and methods: Twenty-two patients with refractory (5) or relapsing Hodgkin's disease (17) were entered and scheduled to receive three courses of ESHAP. Patients suitable for AHT were then given high-dose chemotherapy with CBV (cyclophosphamide, carmustine, and etoposide) plus AHT, whereas responding, non-AHT-suitable patients completed six ESHAP courses. Results: Nine patients achieved complete responses and seven partial responses (overall response rate 73%) with ESHAP. Grade 3-4 myelotoxicity was seen in 13 patients (59%). Nine patients received CBV plus AHT. At a median follow-up time of 50 months (range 6-96), seven patients (32%) are alive and disease-free. Three patients died of toxic effects of ESHAP (1) or CBV (2). Actuarial overall survival and disease-free survival were 35% and 27% at three years. Conclusions: ESHAP is an active regimen for relapsing Hodgkin's disease, with myelosuppression as its dose-limiting toxicity. An increased risk of treatment-related mortality when it is combined with high-dose chemotherapy can not be ruled out.
引用
收藏
页码:593 / 595
页数:3
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