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Outcomes of Hodgkin’s Lymphoma Patients with Relapse or Progression following Autologous Hematopoietic Cell Transplantation

2011; Elsevier BV; Volume: 18; Issue: 3 Linguagem: Inglês

10.1016/j.bbmt.2011.07.020

1523-6536

Panayotis Kaloyannidis, Georgia Voutiadou, Ioannis Baltadakis, Panagiotis Tsirigotis, Alexandros Spyridonidis, Panagiotis Repousis, Artemisia Balta, Simeon Tsimberis, Dimitrios Karakasis, Ioanna Sakellari, Ioannis Dervenoulas, Nicholas Harhalakis, Αchilles Anagnostopoulos,

CNS Lymphoma Diagnosis and Treatment

Patients with relapsed/progressed Hodgkin's lymphoma (HL) following autologous hematopoietic cell transplantation (AHCT) may not have an invariably dismal outcome as previously considered. In a multicenter retrospective study, we evaluated 126 patients who relapsed/progressed after a median of 5 (1-132) months post first AHCT. Management consisted of irradiation, chemotherapy ± irradiation, second HCT, or palliation. Currently, 53 of 126 (42%) patients are alive for a median of 32 months since relapse/progression and 44 (35%) of them remain progression-free. Interval of <12 months to relapse/progression, presence of B-symptoms, and disease refractoriness at first AHCT failure adversely influenced overall survival (P < .05). The type of treatment had no impact on survival. Furthermore, to predict the outcome at the time of relapse/progression, we constructed a prognostic model based on 3 factors: interval of <12 months from first AHCT to relapse/progression, presence of B-symptoms, and pre-AHCT disease refractoriness. Patients with 0 to 1 factors achieved a median survival of 70 months compared to 17 months only in those with 2 to 3 factors (P < .001). This study, the largest reported to date, suggests that selected patients with relapse/progression after first AHCT can be rescued with current treatment modalities. However, relapsed/progressed HL following AHCT still poses a therapeutic challenge, and prospective trials are needed to determine the most appropriate approach in this setting.