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Sequential high-dose chemotherapy tied to similar mortality and more adverse events

-- Jeff Muise

Friday, October 29, 2010 (Last Updated: 11/01/2010)

FRIDAY, Oct. 29 (HealthDay News) -- Patients with relapsed Hodgkin's lymphoma who undergo sequential high-dose chemotherapy prior to stem-cell transplantation have similar mortality but suffer more adverse events than those receiving standard high-dose chemotherapy, according to a study published online Oct. 25 in the Journal of Clinical Oncology.

Andreas Josting, M.D., of the University of Cologne in Germany, and colleagues initially treated patients with relapsed Hodgkin's lymphoma with two cycles of dexamethasone, cytarabine, and cisplatin. Then, those patients whose disease had not progressed were randomized to either: myeloablative therapy with BEAM (carmustine, etoposide, cytarabine, and melphalan) followed by autologous stem-cell transplantation or a sequential high-dose chemotherapy regimen (cyclophosphamide, methotrexate, and etoposide) prior to BEAM.

The researchers found that mortality was similar in the standard high-dose and sequential high-dose regimens (20 and 18 percent, respectively), and no significant difference was seen in freedom from treatment failure over 42 months of observation. Compared to the standard high-dose chemotherapy group, the patients receiving sequential high-dose chemotherapy had longer treatment duration (4.0 versus 2.1 months) and experienced more toxicity and protocol violations.

"Compared with conventional high-dose chemotherapy, additional sequential high-dose chemotherapy is associated with more adverse effects and does not improve the prognosis of patients with relapsed Hodgkin's lymphoma," the authors conclude.

Abstract
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Specialties Hematology & Oncology

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