chapter  28
19 Pages

Stem Cell Transplantation for Hodgkin’s Disease

ByRam Kancherla, Tauseef Ahmed

I. INTRODUCTION Therapy for Hodgkin’s disease has evolved over the past few decades. This malignancy affects 7500 people in the United States yearly. The majority can be cured with radiation and/or combination chemotherapy. However, without appropriate salvage measures, a significant number will die of the disease. Strategies to identify this subgroup and therapeutic plans to best treat them have been the focus of considerable work in recent years. Longterm follow-up results of the MOPP [mechlorethamine, Oncovin (vincristine), procarbazine, prednisone] regimen at the National Cancer Institute (NCI) showed 82% survival at 5 years for patients achieving complete remission (CR) (1). However, none of those who failed to achieve CR survived beyond 5 years. With the use of combination regimens, including MOPP, ABVD (doxorubicin, bleomycin, vincristine, dacarbazine), MOPP alternating with ABVD, hybrid MOPP/ABV (without dacarbazine), and Ch1VPP (chlorambucil, vinblastine, procarbazine, prednisone) regimens, CR can be achieved in 75-90% of patients with advanced disease. Thirty percent of the patients ultimately fail conventional therapy. The prognosis for these patients is extremely poor.