High-Dose Chemotherapy Plus Non-Cryopreserved Autologous Peripheral Blood Stem Cell Transplantation Rescue for Patients With Refractory or Relapsed Hodgkin Disease

A simplified schedule of high-dose chemotherapy consisting of cyclophosphamide (60 mg · kg−1 · d−1 for 2 days), etoposide (15 mg · kg−1 · d−1 for 2 days), and carboplatin (400 mg/m2 per day for 2 days) plus autologous non-cryopreserved peripheral blood stem cells (PBSCs) was used for treatment of patients with relapsed (n = 25) and refractory (n = 3) Hodgkin disease. The use of such PBSCs mobilized by granulocyte colony-stimulating factor after high-dose myeloablative therapy resulted in a rapid, complete, and sustained hematopoietic recovery. The median time to achieve an absolute neutrophil count >0.5 × 109/L was 13 days (range, 7-18 days). The median time to a self-sustained platelet count >20 × 109/L was 15 days (range, 7-20 days). Twelve of the 28 patients (43%) were alive and without disease at a median follow-up of 16 months (range, 9-86 months) for all surviving patients. The estimated 2-year overall survival and disease-free survival for all patients were 45% and 42%, respectively. Thirteen patients died of relapse or progressive disease, 2 died of infection, and 1 was still surviving in relapse by the time of the analysis. The median time to relapse was 10 months (range, 3-28 months) from PBSC infusion. High-dose chemotherapy with short-duration chemotherapy and non-cryopreserved bone marrow is an effective and safe treatment modality for patients with relapsed or resistant Hodgkin lymphoma.