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Outcome predictors of autologous hematopoietic stem cell transplantation in children with relapsed and refractory Hodgkin lymphoma: Single‐center experience in a lower‐middle‐income country
Author(s) -
Abdalla Amr,
Hammad Mahmoud,
Hafez Hanafy,
Zaghloul Mohamed Saad,
Taha Hala,
ElHennawy Gihan,
ElWakeel Madeeha,
Khaled Mohamed,
Mohamed Yasmin,
ElHaddad Alaa
Publication year - 2019
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13531
Subject(s) - medicine , refractory (planetary science) , hematopoietic stem cell transplantation , single center , regimen , lymphoma , cohort , transplantation , salvage therapy , pediatrics , retrospective cohort study , surgery , chemotherapy , physics , astrobiology
Background Children and adolescents with HL have excellent long‐term survival exceeding 95% after combined modality treatment. However, about 20% will either relapse or have PRF. Salvage HDCT followed by AHSCT is considered to be the preferential treatment. Objective To describe the outcome (OS and EFS) and prognostic factors in pediatric patients with relapsed or refractory HL (r/rHL) who underwent AHSCT. Methods We retrospectively included 43 pediatric patients with r/rHL who underwent AHSCT from July 1, 2007, till December 31, 2016, at the Children's Cancer Hospital of Egypt. MAC regimen given was CMV. Results Of the whole cohort, 88.4% of patients achieved CR, while 11.6% had a positive PET scan prior to transplantation. The 3‐year OS and EFS were 85% and 70.6%, respectively. The 3‐year OS for patients > 10 years was 94% versus 65.5% for patients 10 years of age or younger ( P = 0.046). There is strong tendency toward better 3‐year OS for patients with negative PET scan as compared to those with positive PET scan before AHSCT, 89.4% vs 60%, respectively ( P = 0.059). This tendency is also applicable when looking at the 3‐year EFS for the two groups, 78.3% vs 40%, respectively ( P = 0.069). Conclusion Poor predictors of OS were younger age and positive PET scan before AHSCT. The latter, along with single modality treatment before AHSCT, were poor predictors of EFS.