Long-term outcome of autologous stem-cell transplantation in relapsed or refractory Hodgkin's lymphoma

Abstract

These data provide the longest follow-up reported for patients receiving ASCT for relapsed/refractory HL. In addition to previously described prognostic factors, our data show that Hasenclever index <3 influences outcome favorably and attaining CR at ASCT leads to a better outcome.

Brentuximab Vedotin in Transplant-Naïve Relapsed/Refractory Hodgkin Lymphoma: Experience in 30 Patients

“…The standard treatment for patients with HL who are unresponsive to frontline therapy or relapse after primary treatment consists of salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) [3][4][5][6]. Fifty percent of these patients achieve a long-term progression-free survival (PFS).…”

Single or tandem autologous stem-cell transplantation for first-relapsed or refractory Hodgkin lymphoma: 10-year follow-up of the prospective H96 trial by the LYSA/SFGM-TC study group

“…Several studies have shown that single ASCT can provide a cure in roughly 50% of unselected patients. 6,7 Thus, the outcome of intermediate-risk patients treated with single ASCT in our trial was better than the outcome of these unselected patients treated with single ASCT. Moreover, the outcome of poor-risk patients treated with tandem ASCT in our trial was similar to the outcome of these unselected patients treated with single ASCT.…”

“…Concerning the cumulative incidence of SPM, data from retrospective studies are difficult to interpret because of differences in median follow-up, selection of patients (all transplanted patients or only patients who survived ≥2 years after ASCT), period of inclusion, number of treatment lines before ASCT, heterogeneity of treatments, conditioning regimens and source of stem-cells. 7,[17][18][19] Given this, the cumulative incidences of SPM in retrospective studies ranged from 5.8% to 14.7% at 10 years, and from 8% to 15.3% at 15 years. In the present study, considering patients who did not relapse after completing single ASCT (intermediate-risk group), the 10-and 15-year cumulative incidences of SPM were 16% and 24%, respectively, which are higher than in retrospective studies.…”

Heads or tails? Choosing a salvage therapy for relapsed/refractory Hodgkin lymphoma

“…A study by Moskowitz et al reported significantly better event-free survival, progression-free survival (PFS) and overall survival (OS) after HDT/ASCT for patients responding to second-line therapy (60, 62 and 66%, respectively) when compared with those with poor responses (19,23 and 17%, respectively; p < 0.001) [12]. Sirohi et al have reported that patients who were in complete response (CR) or partial response (PR) at the time of HDT/ASCT had better 5-year OS rates (79 and 59%, respectively) when compared with those with disease that was resistant to second-line salvage chemotherapy prior to HDT/ASCT (17%; p < 0.001) [13]. Due to the generally small number of patients and the hetero geneous population enrolled in these studies, analyses comparing different salvage regimens become difficult.…”