Autologous Bone Marrow Transplantation Followed by Involved Field Radiotherapy in Patients with Relapsed or Refractory Hodgkin's Disease

Twenty-six patients with refractory or relapsed Hodgkin's disease were treated with high dose cyclophosphamide, BCNU, etoposide, and thiotepa followed by autologous hematopoietic stem cell rescue. Involved field radiotherapy was given following hematologic recovery in selected patients. The overall response rate to the high dose chemotherapy was 69% with 34% complete responses. Following radiotherapy, the complete response rate increased to 50%. The predicted disease-free survival at two years is 22%. Toxicity with this regimen was significant, with five patients dying as a result of transplant related complications. We conclude that the addition of thiotepa to the standard CBV regimen did not result in improved therapeutic efficacy and possibly contributed significantly to the toxicity of the treatment.