High-Dose therapy and autologous stem cell transplantation for Hodgkin's Lymphoma in relapse or failure after initial chemotherapy: results of the centre National de Greffe de Moelle osseuse de Tunis

In the present study we report the clinical outcome of 27 patients with refractory or relapsed Hodgkin's lymphoma [HL] undergoing autologous peripheral stem-cell transplantation [ASCT]. On transplant, 18 patients had sensitive disease [SD] and 9 resistant disease [RD]. The median time between diagnosis and ASCT was 18 months [range, 7 to 96 months]. The conditioning consisted of BEAM regimen. The 100-day mortality rate was 3%. Three months after transplant, 12 patients transplanted with SD were in complete remission [CR] and only one of the 9 patients transplanted with RD achieved CR. Overall survival and disease-free survival after 3 years were 68% and 60%, respectively. The present results confirm the efficacy and safety of the ASCT in refractory or relapsed HL patients with SD. Other strategies should be investigated for patients with RD

[Autologous stem cell transplantation in multiple mayeloma: first experience of the "centre national de greffe de moelle osseuse" and review of therapeutic strategies]

Alkylating agents administered with prednrisone have been the standard therapy for myeloma over the last three decades. Intensive treatment with autologous hematopoietic support has become the treatment of choice for multiple myeloma patients up to 60 years of age. From march 1999 to January 2000, seven patients with multiple myeloma [stage III] with a median age of 43 years [34-56] received an outologous stem cell transplantation. The myeloablative treatment regimen consisted of high-dose melphalan. All patients had sustained engraftment. The median duration of neutropenia [<500/mm3] was 12 days [11-140] and the median duration of thrombocytopenia[<20000/mm3] was 13 days [11-110]. One patient had a complete remission, one a very good partial remission, and 5 patients had a partial remission. With a median follow- up of 8 months [2-12], all patients are alive, without relapse

[Indications and complications of central venous catheters in oncohematology: a report of 81 cases]

From February 1998 to July 1999, 81 central venous catheters were placed in 41 patients 28 years old [5 to 51 years]. We used the subclavicular anatomic way [Aubaniac] in all cases. The total duration of catheter placement was 2905 days [median of 31 days, range 1 to 165 days]. We observed 1 pneumothorax [1,2%], 3 venous thrombosis [3,7%] and 1 arterial puncture [1,2%]. Catheter-related infections were seen in 8 catheters [2,7 per 1000 catheter-days]. Candida was encountered in 4 cases [50%], Gram-positive cocci in 2 cases [25%], and Gram-negative bacilli in 2 cases [25%]. The improvment of preventive ways, diagnosis techniques [simultaneous quantitative cultures, differential positivity time], and therapeutic methods [treatment without removal of the catheter, antibiotic lock technique, catheter exchange by guidewire] should allow a better treatment of catheter-related infections