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Hematopoietic stem-cell transplantation for Hodgkin's disease (HD): current status.

Abstract：

:Not all patients with Hodgkin's disease (HD) respond to standard chemotherapy and/or radiation, and hematopoietic stem-cell transplantation has been gaining increasing acceptance in the management of HD. Phase II and, to a lesser extent, phase III studies of high-dose chemotherapy and autologous stem cell transplantation carried out at multiple institutions worldwide have proven the feasibility of the procedure and provided extended progression-free survival (and possibly cure) in a sizable number of patients with relapsed or refractory HD. Prognostic factors have been identified by multiple investigators (with response to chemotherapy being the most impressive one) and may ultimately allow a risk-adapted strategy. While early and late treatment-related morbidity and mortality remains an issue, with current supportive care modalities most patients tolerate this procedure with only minor or manageable complications. Disease recurrence remains a problem in many patients, and this can unfortunately occur as late as six or seven years after a seemingly successful transplant. New chemotherapeutic agents and strategies (such as post-transplant maintenance and possibly immunomodulation) will be required to successfully tackle this issue. Allogeneic stem-cell transplantation from HLA-compatible donors has yielded largely unsatisfactory results in the published studies in the literature, despite favorable results in a small minority of patients. Recently, however, newer approaches and strategies (such as the introduction of reduced-intensity, purine analog-based conditioning regimens and possibly cellular immunotherapy in the form of donor lymphocyte infusions) have provided very encouraging early results and seem to brighten the outlook for this procedure.

journal_name

Cytotherapy

journal_title

Cytotherapy

authors

Anderlini P

doi

10.1080/146532402320219754

keywords:

subject

Has Abstract

pub_date

2002-01-01 00:00:00

pages

241-51

issue

3

eissn

1465-3249

issn

1477-2566

pii

S1465-3249(02)71058-X

journal_volume

4

pub_type

杂志文章,评审

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