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

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 iss...Continue Reading