High-Dose Therapy and Autologous Hematopoietic Progenitor Cells Transplantation for Recurrent or Refractory Hodgkin's Lymphoma: Analysis of King Hussein Cancer Center Results and Prognostic Variables.

Purpose. to evaluate the outcome of patients with Hodgkin's lymphoma who underwent autologous transplantation at KHCC bone marrow transplant program. Patients and Methods. Over 6 years, 63 patients with relapsed or refractory Hodgkin's lymphoma underwent high dose chemotherapy followed by autologous transplant. There were 25.4% patients in complete remission (CR), 71.4% with chemotherapy responsive disease at the time of transplant. Prior to conditioning regimen, 56% received two chemotherapy lines, and, 44% received more than two lines. Results. The main outcomes of the study are the rate of complete remission at day 100, overall survival (OS), relapse-free survival (RFS), The impact of the following variables on OS and RFS: (a) disease status at the time of transplant, (b) number of chemotherapy lines prior to conditioning, (c) age group, (d) time of relapse < or >12 months were investigated. The CR at day 100 was 57%. The median overall survival for the whole group was 40.6 months; the median RFS was 20 months. The only factor which significantly impacts the study outcomes was the number of chemotherapy lines prior to conditioning on OS in favor of patients received two lines. Conclusion. In our study only the number of chemotherapy lines received before conditioning had statistically significant impact on OS.

Radiotherapy with concurrent or sequential temozolomide in elderly patients with glioblastoma multiforme.

OBJECTIVE: The objective of this article was to evaluate therapeutic outcomes of elderly patients with glioblastoma multiforme (GBM) treated by surgery followed by combined modality therapy and compare achievable outcomes to those of a younger age population. METHODS AND MATERIALS: Seventy-eight adult patients with histologically confirmed grade IV astrocytoma were treated at King Hussein Cancer Center (Amman, Jordan) between September 2004 and December 2008. Records were retrospectively reviewed and included 55 males and 23 females between 19 and 78 years of age (median age 50 years). This case series included 20 patients aged 60 years or older. All patients underwent craniotomy followed radiotherapy and concurrent or sequential temozolomide. The follow-up ranged from 1 to 56 months (median 9.4 months). RESULTS: The median survival for the whole cohort was 13.8 months. The median survival for patients less than 60 years was 14.3 months and for patients 60 years or older was 12.3 months (P = 0.19). Among elderly patients, radical surgical resection (P = 0.002), concurrent delivery of chemoradiation (0.041) and radiotherapy dose ≥ 5400 cGy (P = 0.0001) conferred statistically significant improvements in overall survival. CONCLUSION: Management of GBM in elderly patients should include maximal surgical resection followed by radiotherapy and temozolomide whenever medically feasible. Outcomes comparable to those obtained in younger age groups can be expected. Our results indicate that concurrent chemoradiation is superior to sequential chemoradiation in these patients.

Advanced gastric cancer in jordan from 2004 to 2008: a study of epidemiology and outcomes.

BACKGROUND: WE REPORT THE EPIDEMIOLOGIC FEATURES AND THE TREATMENT EXPERIENCE OF ADVANCED GASTRIC CANCER (GC) AT KING HUSSEIN CANCER CENTER (KHCC) IN JORDAN, AND WE RETROSPECTIVELY COMPARE OUTCOMES OF TWO DIFFERENT REGIMENS: DCF (docetaxel/cisplatin/5-fluorouracil) vs. ECF (epirubicin/cisplatin/5-fluorouracil). METHODS: Charts of 162 patients with inoperable GC treated between January 2004 and December 2008 were reviewed. A total 143 patients received chemotherapy (ECF = 113; DCF = 30). Choice of regimen was changed from ECF to DCF on January 2008 according to KHCC guidelines. RESULTS: The median patient age was 59 years, with a male:female ratio of 1.8:1. Lymph nodes (67.9%) and liver (49.4%) were the most common sites of metastasis. Primary disease site was stomach in 78.4%, gastroesophageal junction in 16.7%, lower esophagus in 4.9%. Poorly differentiated histology was predominant (46.9%). Anemia (53.7%), pain (48.1%), and reflux (44.4%) were the most common presenting symptoms. Helicobacter pylori infection was present in 79%. Average time between initial symptom and diagnosis was 6.0 months. The overall response rate (ORR) was 59.3% with DCF and 32.6% with ECF (P = .01). Time to tumor progression (TTP) was 6.9 months with DCF and 5.9 months with ECF (P = .005). Median survival was 11.0 months with DCF and 10.2 months with ECF (P = .17). CONCLUSION: Some epidemiologic features of GC in Jordan mimic those of high-risk areas. Our outcomes of chemotherapy are comparable to internationally reported data and suggest superiority of DCF over ECF in terms of ORR and TTP.