Autologous Bone Marrow Transplantation - Blog Science Connections

Natural History of Relapsed Hodgkin's Disease
and Results of the Bloomsbury
Autograft Studies
J. Gribben, A. H. Goldstone, D. C. Linch, B. Vaughan-Hudson,
and G. Vaughan-Hudson
The prognosis of patients with advanced Hodgkin's disease has improved
dramatically with the development of combination chemotherapy. DeVita
and colleagues (1) have shown that more than 50% of patients with advanced
Hodgkin's disease are cured with chemotherapy alone. However, the fate of
those patients who fail first-line therapy or who relapse has been more difficult
to establish. Bonadonna and coworkers (2) developed ABVD (Adriamycin
[doxorubicin], bleomycin, vinblastine, dacarbazine) to meet the needs of
patients who were resistant to MOPP (mechlorethamine, Oncovin [vincristine],
procarbazine, prednisone) therapy, and his group reported a 59%
complete remission (CR) rate with an estimated 5-year survival of 38% and
advocated the use of MOPP/ABVD alternating therapy in stage IV disease (3).
However, attempts to confirm these results in other heavily pretreated
patients have had limited success (4). It has previously been shown also that
high-dose therapy with autologous bone marrow transplantation (ABMT) can
produce a high response rate in advanced relapsed Hodgkin's disease, but
most studies have been carried out in patients with very advanced disease
(5,6).
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