Treatment-Related Deaths and Second Cancer Risk After Autologous Stem-Cell Transplantation for Hodgkin's Disease

摘要: Autologous stem-cell transplantation has become a widely used therapy in Hodgkin's disease (HD). To appreciate the early and late risks associated with this procedure, its lethal toxicity effects on incidence of secondary cancers were studied. Data related to 467 French patients grafted from 1982 1995 for primary sensitive (PSD, 22%), refractory (PRD, 18%), first relapse (R1, 45%), or subsequent relapses (R2, 15%) analyzed. Grafted PRD, R1; n = 393) matched (3 controls 1 case) age, gender, clinical stage, B symptoms, time at risk 1179 conventionally treated issued international databases. The proportional hazards (Cox) model was assess relative (RR). Among patients, 8% died 18 occurred leading 5-year cumulative rate 8.9%. In series, factors second cancer age >/=40 years (RR 3.73, P .007) use peripheral blood stem cells as source graft 3.10, .03). ungrafted development 2.90, < .001), versus no 5.22, .006), PRD other 3.86, .033), 2.04, . 024). Solid tumors more frequent than 5.19, .001) although myelodysplasia acute myeloid leukemia similar two groups. We conclude that high-dose chemotherapy administered first-line treatment after is an acceptable toxic death rate. not significantly increased autologous HD, whereas solid exists. stem-cell-associated among needs further investigations.