Abstract
Four patients less than 20 years of age with Hodgkin's disease, who had developed either second or third relapse, were treated with high-dose chemotherapy followed by peripheral blood stem cell transplantation (PBSCT). Peripheral blood stem cells (PBSC) were collected after the administration of high-dose cytosine arabinoside (HD-AraC, 1g/m2 ×4). The conditioning regimen for PBSCT contained cyclophosphamide (50mg/m2 ×4), etoposide (150mg/m2 ×6) and ranimustine (250mg/dose ×1) (CVM regimen). A significant tumor regression was thus obtained after HD-AraC in 3 cases. The amount of PBSC harvested ranged from 1.2 to 4.5 × 105/kg CFU-GM. Several cycles of conventional therapy were performed prior to the transplantation. PBSCT was done only after achieving a complete remission (CR) in 3 cases, but during relapse in another case. All patients showed both a rapid and sustained hematological recovery without any critical side effects. After this treatment, the 3 patients who were in CR at transplantation maintained a CR for 27, 26. and 4 months, respectively, while another developed a bone relapse despite achieving a CR by PBSCT. These results suggest that a combination of HD-AraC and CVM followed by PBSCT is therefore considered to be beneficial in the treatment of relapsed Hodgkin's disease.