Autologous Bone Marrow Transplantation - Blog Science Connections

ABMT in Hodgkin's Disease 211
50%. A small group of patients (8%) had no response to first-line therapy and
had a 2-year survival of less than 25%. Most of these patients died within 6
months, however, and therefore would not have been eligible for ABMT. If one
excludes from analysis those who died early in this group, then the 2-year
survival rate was 50% and the 5-year rate less than 25%.
Various factors were coanalyzed to identify a poor-risk group of patients
whose primary treatment failed. Those factors found to be significant were
stage 111 and IV disease, the presence of B symptoms, an erythrocyte
sedimentation rate greater than 39 mm in the first hour, and grade II
histological findings. Patients having these characteristics represented about
30% of all whose treatment failed. These patients had a 2-year survival rate of
60% and a 5-year rate of 25% (Fig 2).
If one took all those whose first-line therapy failed and gave second-line
therapy—either radiotherapy or a different chemotherapy—then 89/144
(62%) entered second CR. Of those who achieved a second CR, the survival
rate from commencing second-line chemotherapy was 90% at 2 years and
70% at 5 years, with no difference between those receiving radiotherapy or a
second chemotherapy (Fig 3). Those who failed to achieve a second CR had
a 2-year survival rate of 60% and a 5-year rate of 25%.
The fate of patients whose alternating frontline chemotherapy failed is
much less well known, though Santoro and coworkers reported on a small
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