Aim:
Prior studies showed that overexpression of bcl-2 and p53 have negative impact on outcome with primary therapy. The study sought to determine if the comprehensive second-line program could overcome these poor prognostic features.

Conclusions:
Researchers concluded that despite the evidence that p53 and bcl-2 overexpression may predict a worse prognosis with initial treatment, it appears that the approach of incorporating ICE and HDT/ASCT may overcome the significance of these biological
markers at relapse.

Official Title

Conditions

Study Type

Study Design

Immunohistochemistry staining for bcl-2, bim (a bcl-2 family marker), were performed on biopsy tissue p53; samples were considered positive if any Reed-Sternberg (RS) cells stained for bcl-2 or bim, and if more than 50% stained for p53, at any staining intensity.

Further Details

Treatment:At MSKCC, ICE (ifosfamide, carboplatin, etoposide) is incorporated as second-line chemotherapy prior to HDT/ASCT in a comprehensive treatment program.About 50% of relapsed patients achieved long-term remissions after high-dose chemoradiotherapy and autologous stem cell transplantation (HDT/ASCT).Results: Median PFS was 4.8 years, median OS was not reached, and median follow-up was 5.7 years. Bcl-2 was overexpressed in 19(27%), bim in 22 (32%), and p53 in 20 (29%) patients. Expression of bcl-2, bim, or p53 had no significant association with PFS or OS. Five-year PFS rates for positive vs. negative cases were 52.6% vs 50% for bcl-2, 54.5% vs 50% for bim, and 50% vs 51% for p53 (all p=NS). The 3 factor clinical model (B symptoms at relapse, extranodal disease and complete remission duration of less than 1 year) remained highly significant (0/1 vs 2/3 factors) for PFS and OS (p=0.002 and p=0.0003, respectively).

Study Start

Eligibility & Criteria

Indication: Relapsed/Refractory Hodgkin’s Lymphoma

Total Enrolment

71 patients had sufficient tissue available. 35 patients (49%) had disease progression and 28 (39%).

Contact Details

Abstract 2073 ASH 2005Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

All content and media on the HealthEngine Blog is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this Website. If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately.