Outcome and prognostic factors in advanced Hodgkin's disease treated with high-dose chemotherapy and autologous stem cell transplantation: a study of 341 patients

Czyż, Jarosław; Dziadziuszko, Rafał; Knopińska-Postuszuy, Wanda; Hellmann, Andrzej; Kachel, L; Hołowiecki, Jerzy; Goździk, Jolanta; Hansz, J; Avigdor, Abraham; Nagler, Arnon; Osowiecki, Michał; Walewski, Jan; Mensah, Patrycja; Jurczak, Wojciech; Skotnicki, Aleksander B.; Sędzimirska, Mariola; Lange, Andrzej; Sawicki, Waldemar; Sułek, K; Wach, Małgorzata; Dmoszyńska, Anna; Kuś, A.; Robak, Tadeusz; Warzocha, Krzysztof

doi:10.1093/annonc/mdh304

Cited by 48 publications

(35 citation statements)

References 36 publications

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“…In our study, 3y OS was 70% in all patients who underwent autologous HSCT (Fig. 1A), and was comparable to that in previous studies [4,12,13]. In addition, OS was favorable even in patients who underwent autologous HSCT in the disease status other than CR, although the disease status was associated with OS, which was similar to the results in many other studies [4,12,13].…”

Section: Discussionsupporting

confidence: 91%

“…This study was planned by the Adult Lymphoma Working Group of JSHCT, and was approved by the data management committee of TRUMP and by the institutional review board of Nagoya University School of Medicine. 12 Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan; 13 Department of Hematopoietic Stem Cell Transplantation Data Management and Biostatistics, Nagoya University School of Medicine, Nagoya, Japan; 14 Cancer Center, Shimane University Hospital, Shimane, Japan Statistical considerations. Differences between groups were examined using Fisher's exact test for categorical variables.…”

Section: Methodsmentioning

confidence: 99%

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The role of hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma

et al. 2014

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on behalf of the Adult Lymphoma Working Group of the Japanese Society for Hematopoietic Cell TransplantationThe optimal treatment strategy with the use of hematopoietic stem cell transplantation (HSCT) for relapsed and refractory Hodgkin lymphoma (HL) remains unclear. We performed a retrospective analysis using registry data from the Japanese Society for Hematopoietic Cell Transplantation. Adult patients with HL who underwent a first autologous or a first allogeneic HSCT between 2002 and 2009 were included. Patients who underwent HSCT in first complete remission (CR) were excluded. Autologous and allogeneic HSCT were performed in 298 and 122 patients, respectively. For autologous HSCT, overall survival at 3 years (3yOS) was 70%, and sex, age, disease status, and performance status (PS) at HSCT were prognostic factors. OS was favorable even in patients who underwent autologous HSCT in disease status other than CR. For allogeneic HSCT, 3yOS was 43%, and sex and PS at HSCT were prognostic factors. Disease status at HSCT, previous autologous HSCT, and conditioning intensity did not affect OS. Moreover, graft-versus-host disease did not affect progression-free survival or relapse/progression rate. A first allogeneic HSCT without a previous autologous HSCT was performed in 40 patients. 3yOS was 45%, and was significantly inferior to that in patients who underwent their first autologous HSCT. This result was retained after the correction by the different patient characteristics according to the type of HSCT. In conclusion, autologous HSCT is effective in prolonging survival in patients with relapsed and refractory HL. Allogeneic HSCT might be beneficial even to relapsed HL after autologous HSCT, although establishing the role of allogeneic HSCT remains a challenge.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

The role of hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma

et al. 2014

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“…Prior studies of other malignancies have reported an 8-10% cumulative incidence of second malignancies after HDCT/ASCR. [22][23][24][25][26] The intensive chemotherapy used for treatment might induce a second malignancy in patients with a germline predisposition to cancer. In the study conducted by Kleinerman et al, 2 radiation increased the risk of second malignancies in patients with hereditary retinoblastoma, but there was no development of a subsequent malignancy among the hereditary patients treated with conventional chemotherapy alone.…”

Section: Discussionmentioning

confidence: 99%

Tandem high-dose chemotherapy and autologous stem cell rescue in children with bilateral advanced retinoblastoma

et al. 2008

Bone Marrow Transplant

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“…Several studies in patients with relapsed Hodgkin's lymphoma have reported cumulative probability rates for 5-year OS and PFS after HDC and ASCT of 51-75 and 42-52%, respectively. [3][4][5][6][7][8][9][10][11][12] Other studies which have focussed on patients with chemorefractory relapse 13 or primary resistant disease 14 have demonstrated lower corresponding figures for outcome.…”

Section: Introductionmentioning

confidence: 99%

LACE-conditioned autologous stem cell transplantation for relapsed or refractory Hodgkin's lymphoma: treatment outcome and risk factor analysis in 67 patients from a single centre

Perz

Giles

Szydlo

et al. 2006

Bone Marrow Transplant

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High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a recognized treatment option for patients with relapsed Hodgkin's lymphoma. We have analysed 67 patients who underwent ASCT after LACE (lomustine (CCNU), cytarabine (Ara-C), cyclophosphamide, etoposide) conditioning for relapsed (n ¼ 61) or primary refractory (n ¼ 6) Hodgkin's lymphoma. The 100-day treatment-related mortality was 3%. With a median follow-up of 67 months (range 3.3-161.0) the probabilities of overall survival (OS) and progression-free survival (PFS) at 5 years were 68 and 64%, respectively. Probabilities for OS and PFS at 5 years for patients with chemosensitive relapse (n ¼ 40) were 81 and 78% versus 50 and 35%, respectively, for patients (n ¼ 27) with chemoresistant relapse (P ¼ 0.012 for OS, P ¼ 0.002 for PFS). In multivariate analysis mixed cellularity classical or lymphocyte-depleted classical histology subtype and haemoglobin level of 10 g/dl or less at the time of ASCT were identified as risk factors for worse OS, whereas stage III or IV disease at diagnosis and disease status at ASCT other than complete or partial remission predicted inferior PFS. LACE followed by ASCT is an effective treatment for the majority of patients with chemosensitive relapsed Hodgkin's lymphoma and a proportion of chemorefractory patients also benefit.

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Outcome and prognostic factors in advanced Hodgkin's disease treated with high-dose chemotherapy and autologous stem cell transplantation: a study of 341 patients

Abstract: HDC/ASCT should be considered early in the course of disease for patients with a response after standard therapy.

Cited by 48 publications

References 36 publications

The role of hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma

The role of hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma

Tandem high-dose chemotherapy and autologous stem cell rescue in children with bilateral advanced retinoblastoma

LACE-conditioned autologous stem cell transplantation for relapsed or refractory Hodgkin's lymphoma: treatment outcome and risk factor analysis in 67 patients from a single centre

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