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Autologous stem cell transplant for early relapsed/refractory Hodgkin lymphoma: results from two transplant centres
Author(s) -
Smith Stephen D.,
Moskowitz Craig H.,
Dean Robert,
Pohlman Brad,
Sobecks Ronald,
Copelan Edward,
Andresen Steven,
Bolwell Brian,
Maragulia Jocelyn C.,
Vanak Jill M.,
Sweetenham John,
Moskowitz Alison J.
Publication year - 2011
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2011.08616.x
Subject(s) - medicine , refractory (planetary science) , salvage therapy , lymphoma , transplantation , cancer , disease , surgery , oncology , chemotherapy , physics , astrobiology
Summary Prior series have demonstrated that early relapsed (within 1 year) or refractory Hodgkin lymphoma (HL) is associated with poor prognosis. To determine the outcome for patients with early relapsed/refractory HL in the modern era, we combined data from two large transplant centres, Cleveland Clinic Taussig Cancer Institute (CCTCI) and Memorial Sloan‐Kettering Cancer Center (MSKCC), and analysed consecutive patients transplanted for relapsed/refractory HL following induction failure or remission durations of <1 year. Two hundred and fourteen patients were analysed and the event‐free survival (EFS) and overall survival (OS) at 6 years for all patients were 45% and 55%, respectively. Factors significant for prognosis in multivariate analysis were extranodal disease and bulky disease (≥5 cm). Patients with 0, 1, or 2 risk factors achieved 6 year EFS of 65%, 47%, and 24% and 6 year OS of 81%, 55%, and 27%, respectively. Patients with the sole risk factor of early relapsed/refractory disease achieved good outcomes in this large series; however the presence of bulk and/or extranodal disease significantly reduced EFS and OS. Patients with these additional risk factors are best suited for clinical trials investigating novel salvage regimens and post‐transplant maintenance strategies.