Hodgkin's lymphoma (HL) is a lymphoid malignancy with excellent prognosis, however nearly 15% of the patients in early stages and 35% in advanced stages have progressive disease after initial treatment. Autologous bone marrow or hematopoietic stem cell transplantation (ABMT) are the treatments of choice in these cases. This report presents the therapeutic approach and the outcome of HL patients who experience relapse after or are refractory to ABMT. Of 38 patients with LH who underwent ABMT between April 1996 and November 2005, 17 presented with relapsed/refractory disease and were included in this analysis. In these cases, the choice of rescue therapy varied upon the clinical conditions of each patient and was based on previously unused chemotherapy agents. After ABMT, 10 (59%) of the 17 patients were in complete remission, one (6%) in partial remission and six (35%) were refractory. Fourteen of the 17 patients received different schemes of rescue therapy at the time of ABMT failure, one patient was treated exclusively with radiotherapy and two died before any treatment. We observed an overall response rate of 57.4% (95% CI: 23.2 - 90.7%). The median progression-free survival was 19 months and the median overall survival was 32 months. Despite ABTM, relapsed/refractory LH can not be cured with currently available chemotherapeutic agents, the patients had long survival times with frequent exacerbations of the diseas.
Hodgkin´s lymphoma; bone marrow transplantation; relapsed disease; refractory disease
