engleski

Gemcitabine in the treatment of relapsed and refractory Hodgkin´s disease

Introduction: Patients with refractory Hodgkin’ s disease or relapsing after high-dose therapy and autografting have a bad prognosis. We present our experience with gemcitabine in this setting. Patients and methods: We treated 14 patients with relapsed or refractory Hodgkin’ s disease with gemcitabine. The treatment was given on a compassionate case basis, off-label and not according to a study protocol. Patients were 17-46 years old. One was in stage IA, 2 in IIIB and 11 in IVB. Nine were irradiated, 8 autografted, and one autografted and allografted. Gemcitabine was administered at a starting dose of 1g/m2 on days 1 and 8 every 3 weeks in combination with steroids. Results: Median follow-up was 10 months. Hematological toxicity grade 3-4 occurred in 12 patients leading to dose reductions. One patient died of neutropenic sepsis. No other non-hematological toxicity was seen. The response rate was 64% with 6 patients achieving CR and 3 PR. Median time to treatment failure was 9 months and survival 11 months. Responses were seen in previously transplanted patients and in patients refractory to previous treatment. The longest responder is still in CR for over 68 months. Conclusion: Gemcitabine is an effective treatment for Hodgkin’ s disease. Dose reductions are often necessary in heavily pretreated patients.

Hodgkin’ s disease; relapse; therapy; gemcitabine

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