Autologous hematopoietic stem cell transplantation in classical Hodgkin's lymphoma

Abstract

Background Hodgkin's lymphoma has high rates of cure, but in 15% to 20% of general patients and between 35% and 40% of those in advanced stages, the disease will progress or will relapse after initial treatment. For this group, hematopoietic stem cell transplantation is considered one option of salvage therapy. Objectives To evaluate a group of 106 patients with Hodgkin's lymphoma, who suffered relapse or who were refractory to treatment, submitted to autologous hematopoietic stem cell transplantation in a single transplant center. Methods A retrospective study was performed with data collected from patient charts. The analysis involved 106 classical Hodgkin's lymphoma patients who were consecutively submitted to high-dose chemotherapy followed by autologous transplants in a single institution from April 1993 to December 2006. Results The overall survival rates of this population at five and ten years were 86% and 70%, respectively. The disease-free survival was approximately 60% at five years. Four patients died of procedure-related causes but relapse of classical Hodgkin's lymphoma after transplant was the most frequent cause of death. Univariate analysis shows that sensitivity to pre-transplant treatment and hemoglobin < 10 g/dL at diagnosis had an impact on patient survival. Unlike other studies, B-type symptoms did not seem to affect overall survival. Lactic dehydrogenase and serum albumin concentrations analyzed at diagnosis did not influence patient survival either. Conclusion Autologous hematopoietic stem cell transplantation is an effective treatment strategy for early and late relapse in classical Hodgkin's lymphoma for cases that were responsive to pre-transplant chemotherapy. Refractory to treatment is a sign of worse prognosis. Additionally, a hemoglobin concentration below 10 g/dL at diagnosis of Hodgkin's lymphoma has a negative impact on the survival of patients after transplant. As far as we know this relationship has not been previously reported.

High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center

“…For this group, high-dose chemotherapy followed by autologous HSCT has become the treatment of choice. 26 , 27 This leads to a significant increase in PFS, but has no effect on OS. Of 30 relapsed patients in this study, 20 underwent an autologous HSCT after achieving a second remission induced by chemotherapy and 85% of them are alive at five years.…”

Validation of the GATMO score in predicting non‐relapse mortality following hematopoietic cell transplant in multiple myeloma patients

“…Autologous hematopoietic cell transplant (AHCT) remains integral to the management of multiple myeloma (MM). 1,2 AHCT can be associated with significant morbidity and non-relapse mortality (NRM) especially in patients with multiple comorbidities; hence, patients are carefully screened for eligibility determination. [3][4][5] In 2019, the Grupo Argentino De Transplante De Medula Osea (GATMO) developed a scoring system to predict overall survival (OS) and NRM post-AHCT.…”

The Impact of Human Microbiotas in Hematopoietic Stem Cell and Organ Transplantation

“…Hematopoietic stem cell transplantation (HSCT) is a clinical procedure involving the infusion of healthy donor multipotent hematopoietic stem cells (HSCs) to correct a patient's damaged/ defective bone marrow/immune system and consequently reestablish a normal hematopoietic function (16,17). It is a standard course of treatment for a variety of fatal malignant and non-malignant blood disorders such as leukemias, severe aplastic anemia, multiple myeloma, immune deficiency disorders, and lymphomas (18)(19)(20)(21)(22)(23)(24). Broadly speaking, HSCT has three clinicaluse cases.…”