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

Single-agent high-dose melphalan followed by auto-SCT for relapsed and refractory Hodgkin lymphoma in children and adolescents

“…[2][3][4]6 More commonly used conditioning regimens in adults and children have achieved event-free survival rates between 40 and 60%. 2,[4][5][6]10,12,15 Although the NRM for those with HL treated with auto-SCT has decreased with time, the use of HDC with or without RT is not without toxicity. The NRM with CBV þ /ÀP has been reported between 23 and 26%, and when second malignancies are excluded, has been reported between 5 and 14%.…”

“…2,3 Most of the reported data describe an adult rather than a pediatric population, and the few reported pediatric series involve small numbers of patients. 2,[4][5][6] However, several studies suggest that the adult literature describing the use of auto-SCT in relapsed/refractory HL can be extrapolated to children and young adults. 1,6 Numerous HDC regimens have been used before autologous stem cell rescue.…”

“…1,6 Numerous HDC regimens have been used before autologous stem cell rescue. 2,[4][5][6][7][8][9][10][11][12] More commonly these regimens include CY, carmustine and etoposide, with or without cisplatin (CBV þ /ÀP) or BEAM. 7,10,13 The University of Calgary/Tom Baker Cancer Centre has used single-agent high-dose melphalan (HDM) as a local institutional protocol for over 20 years for adults with relapsed/refractory HL with comparable efficacy, reduced short-term morbidity and lower costs compared with more standard regimens.…”

Interferon-α after autologous stem cell transplantation in pediatric patients with advanced Hodgkin's lymphoma

“…In both adult and pediatric patients, recurrence of HL was the main cause of failure after ASCT. [2][3][4][5][6]21 The relapse rate in several pediatric series ranged from 25 to 69%. Lieskovsky et al 4 noted that about half of the relapses occurred in previously uninvolved sites.…”

“…Among such reports, a 5-year overall survival (OS) was 43-95%, but the EFS was 31-62%. [3][4][5][6] Most treatment failures were the result of relapse of the primary disease and patients with multiply relapsed HL fared poorly. Various strategies have been used to reduce the risk of tumor recurrence, without much success.…”