Outcomes in relapsed Hodgkin's lymphoma treated with autologous and allogeneic hematopoietic cell transplantation at the Pontificia Universidad Católica de Chile

Abstract

IntroductionHodgkin's lymphoma is a highly curable disease. Autologous and reduced intensity allogeneic hematopoietic cell transplantations are alternatives to treat relapsed patients. Here, we report on the results of one service using these procedures.MethodsAll patients who underwent transplantations in our institution between 1996 and 2014 were retrospectively studied and demographics, toxicities and survival rate were analyzed.ResultsThis study evaluated 24 autologous and five reduced intensity allogeneic transplantations: the median ages of the patients were 29 and 32 years, respectively. At the time of autologous transplantation, ten patients were in complete remission, nine had chemosensitive disease but were not in complete remission, three had refractory disease and the status of two is unknown. In the allogeneic group, two were in complete remission and three had chemosensitive disease. The 5-year overall survival after autologous transplantation was 42% (66% patients were in complete remission, 37% had chemosensitive disease with incomplete remission and 0% had refractory disease) and 1-year overall survival after allogeneic transplantation was 80%. Transplant-related mortality was 0% in patients conditioned with the ifosfamide/carboplatin/etoposide (ICE), carmustine/etoposide/cyclophosphamide (BEC) and carmustine/etoposide/cytarabine/melphalan (BEAM) regimens, 37% in patients conditioned with busulfan-based regimens and 20% in allogeneic transplantations.ConclusionsHematopoietic cell transplantation for relapsed Hodgkin's lymphoma is a potentially curative procedure especially in patients in complete remission at the time of autologous transplantations, and possibly after allogeneic transplantations. Further studies are necessary to clarify the role of allogeneic transplantations in the treatment of relapsed Hodgkin's lymphoma.

Treatment pathways and resource use associated with recurrent Hodgkin lymphoma after autologous stem cell transplantation

“…9 Our results compare favourably with these data and the appropriate selection of patients most likely to benefit from alloSCT is likely to have contributed to the high survival rate. Crucially, the demographic data indicate that these patients were younger and had relapsed later than those treated with palliative treatment or BSC; this is important as outcomes are generally considered poor for patients with early relapse (within 6–12 months of ASCT).…”

“…Recent studies found the median overall survival following relapse post ASCT to be only 25–32 months, 7 , 8 and a study of patients with relapsed HL demonstrated 5-year overall survival rates of 42% in 24 patients post ASCT and 1-year overall survival rates of 80% in five patients following allo. 9 Our results compare favourably with these data and the appropriate selection of patients most likely to benefit from alloSCT is likely to have contributed to the high survival rate. Crucially, the demographic data indicate that these patients were younger and had relapsed later than those treated with palliative treatment or BSC; this is important as outcomes are generally considered poor for patients with early relapse (within 6–12 months of ASCT).…”

Hodgkin’s Lymphoma - evaluation of patients submitted to Autologous transplantation of hematopoietic cells in the Hematology Service of the Hospital Walter Cantídio – Fortaleza, Brazil.

“…Some conditioning regimens suggest adding bortezomib to other drugs, but there was no significant difference in the outcome. 14 The final evaluation of the transplanted HL patients showed an overall survival rate of 88.5% and 61.5% disease-free survival at six years, with an overall survival of chemosensitive patients of 81% and 72.6% in chemoresistant ones, results comparable to other transplant centers 15,16 …”

Ajuste de intensidad para el trasplante hematopoyético alogénico en leucemia aguda

“…En nuestro país, el trasplante ha aumentado progresivamente y las experiencias en mieloma múltiple 4 , enfermedad de Hodgkin 5 , leucemia linfoblástica aguda 7 y cordón umbilical como fuente alternativa de donantes 6 han sido comparables con los centros de referencia. Sin embargo, no tenemos información con respecto al AloTH en leucemias agudas de acuerdo a la edad.…”