%0 Journal Article %1 Pfreundschuh.1994.DexaBEAM %A Pfreundschuh, Michael %A Rueffer, U. %A Lathan, B. %A Schmitz, Norbert %A Brosteanu, Oana %A Hasenclever, Dirk %A Haas, R. %A Kirchner, H. %A Koch, P. %A Kuse, R. %D 1994 %J Journal of clinical oncology : official journal of the American Society of Clinical Oncology %K IMISE-Publikationen %N 3 %P 580–586 %T Dexa-BEAM in patients with Hodgkin's disease refractory to multidrug chemotherapy regimens: a trial of the German Hodgkin's Disease Study Group %V 12 %X PURPOSE: A prospective phase II study was conducted to evaluate the efficacy of dexamethasone, carmustine, etoposide, cytarabine, and melphalan (Dexa-BEAM) as salvage chemotherapy for patients with Hodgkin's disease. PATIENTS AND METHODS: Fifty-five patients progressing on or relapsing after eight- or 10-drug chemotherapy (cyclophosphamide, vincristine, procarbazine, and prednisone plus doxorubicin, bleomycin, vinblastine, and dacarbazine COPP+ABVD or COPP+ABV+ifosfamide, methotrexate, etoposide, and prednisone IMEP) were treated with Dexa-BEAM. Patients who responded after two cycles of Dexa-BEAM either continued treatment for another two to three cycles or received high-dose chemotherapy/autologous bone marrow transplantation (HDCT/ABMT) with cyclophosphamide, etoposide, and carmustine (BCNU) (CVB) as conditioning regimen. RESULTS: Seventeen patients (31\%) achieved a complete remission and 16 (29\%) a partial remission, resulting in a response rate of 60\% (95\% confidence interval, 46\% to 73\%). Progressive disease developed in 18 patients. Toxicity of Dexa-BEAM was acceptable with pronounced, but temporary World Health Organization (WHO) grade III/IV granulocytopenia and thrombocytopenia occurring in more than 90\% of all courses. Two patients died of sepsis during granulocytopenia. Three prognostic subgroups could be distinguished: (1) patients progressing on initial chemotherapy, (2) patients relapsing within 12 months, and (3) patients with late relapses. The response rates for these groups were 52\%, 60\%, and 83\%, and the median survival duration 12, 29, and 40+ months, respectively. In a nonrandomized comparison, the survival of patients who responded to two cycles of Dexa-BEAM and had additional cycles of Dexa-BEAM (n = 14) was not different from those responding patients who underwent HDCT/ABMT (n = 19). However, the power to detect a 20\% survival difference was only 33\% in this comparison. CONCLUSION: Dexa-BEAM is an effective salvage treatment for patients with Hodgkin's disease who fail to respond to multidrug chemotherapy. Efficacy and toxicity are comparable to HDCT/ABMT and underline the need for prospective randomized trials to define better the role of HDCT with and without ABMT in these patients.

@article{Pfreundschuh.1994.DexaBEAM, abstract = {PURPOSE: A prospective phase II study was conducted to evaluate the efficacy of dexamethasone, carmustine, etoposide, cytarabine, and melphalan (Dexa-BEAM) as salvage chemotherapy for patients with Hodgkin's disease. PATIENTS AND METHODS: Fifty-five patients progressing on or relapsing after eight- or 10-drug chemotherapy (cyclophosphamide, vincristine, procarbazine, and prednisone plus doxorubicin, bleomycin, vinblastine, and dacarbazine [COPP+ABVD] or COPP+ABV+ifosfamide, methotrexate, etoposide, and prednisone [IMEP]) were treated with Dexa-BEAM. Patients who responded after two cycles of Dexa-BEAM either continued treatment for another two to three cycles or received high-dose chemotherapy/autologous bone marrow transplantation (HDCT/ABMT) with cyclophosphamide, etoposide, and carmustine (BCNU) (CVB) as conditioning regimen. RESULTS: Seventeen patients (31\%) achieved a complete remission and 16 (29\%) a partial remission, resulting in a response rate of 60\% (95\% confidence interval, 46\% to 73\%). Progressive disease developed in 18 patients. Toxicity of Dexa-BEAM was acceptable with pronounced, but temporary World Health Organization (WHO) grade III/IV granulocytopenia and thrombocytopenia occurring in more than 90\% of all courses. Two patients died of sepsis during granulocytopenia. Three prognostic subgroups could be distinguished: (1) patients progressing on initial chemotherapy, (2) patients relapsing within 12 months, and (3) patients with late relapses. The response rates for these groups were 52\%, 60\%, and 83\%, and the median survival duration 12, 29, and 40+ months, respectively. In a nonrandomized comparison, the survival of patients who responded to two cycles of Dexa-BEAM and had additional cycles of Dexa-BEAM (n = 14) was not different from those responding patients who underwent HDCT/ABMT (n = 19). However, the power to detect a 20\% survival difference was only 33\% in this comparison. CONCLUSION: Dexa-BEAM is an effective salvage treatment for patients with Hodgkin's disease who fail to respond to multidrug chemotherapy. Efficacy and toxicity are comparable to HDCT/ABMT and underline the need for prospective randomized trials to define better the role of HDCT with and without ABMT in these patients.}, added-at = {2014-10-10T19:55:57.000+0200}, author = {Pfreundschuh, Michael and Rueffer, U. and Lathan, B. and Schmitz, Norbert and Brosteanu, Oana and Hasenclever, Dirk and Haas, R. and Kirchner, H. and Koch, P. and Kuse, R.}, biburl = {https://www.bibsonomy.org/bibtex/28ac3c0bdb7fbe3499db20a17f25f6ad7/drtester}, interhash = {3005d841759b2e60b833298971b75c89}, intrahash = {8ac3c0bdb7fbe3499db20a17f25f6ad7}, journal = {Journal of clinical oncology : official journal of the American Society of Clinical Oncology}, keywords = {IMISE-Publikationen}, number = 3, pages = {580–586}, timestamp = {2014-12-03T00:09:01.000+0100}, title = {Dexa-BEAM in patients with Hodgkin's disease refractory to multidrug chemotherapy regimens: a trial of the German Hodgkin's Disease Study Group}, volume = 12, year = 1994 }