That tallies with the current manufacturers' guidelines for the use of triamcinolone, which state: "Patients with hay fever or pollen asthma who are not responding to pollen administration and other conventional therapy may obtain a remission of symptoms lasting throughout the pollen season after a single injection of 40mg to 100mg".
This intervention obtains a remission rate of 30 40% at 1-year follow-up [ 5, 6].
However, no survival benefit of obtaining a remission prior to the second HSCT was noted (p=0.55, data not shown).
Treatment was defined as active when patients received active cancer treatment with intention to cure or to obtain a remission (radiotherapy or chemotherapy within 1 month, and surgery during the stay); many patients could be classified as receiving active treatment even if they had metastatic disease.
In an early trial of fludarabine as a single agent in previously treated patients, 11 of 33 patients (33%) obtained a complete remission, 13 (39%) a nodular partial remission, and two (6%) a partial response (PR) for an overall response rate of 79%. 31 The major morbidity was infection with febrile episodes in 13% of the courses.
Of the 379 patients initially entered into the trial, 35% obtained a complete remission.
Only two patients, both with SCLE, obtained a sustained remission after withdrawing medication.
Of these, 49 patients showed a partial response (35%), 1 patient obtained a complete remission (1%), 32 patients achieved a stable disease (23%) and 40 patients (29%) progressed during chemotherapy.
Eight patients had brain metastases (treated with radiotherapy), seven patients had received radiotherapy for bone metastases, seven patients had received radiotherapy for lung metastases and 13 patients had obtained a partial remission following chemotherapy.
101 DeLavallade et al 102 published similar results, whereby newly diagnosed patients who obtained a complete cytogenetic remission by 12 months had better progression-free survival and overall survival, but achieving a major molecular remission confirmed no advantage.
