Autologous stem cell transplant for early relapsed/refractory Hodgkin lymphoma: results from two transplant centres

作者：Smith Stephen D; Moskowitz Craig H; Dean Robert; Pohlman Brad; Sobecks Ronald; Copelan Edward; Andresen Steven; Bolwell Brian; Maragulia Jocelyn C; Vanak Jill M; Sweetenham John; Moskowitz Alison J^*

来源：British Journal of Haematology, 2011, 153(3): 358-363.

DOI：10.1111/j.1365-2141.2011.08616.x

• Hodgkin lymphoma
• stem cell transplantation
• relapse
• refractory

P>Prior series have demonstrated that early relapsed (within 1 year) or refractory Hodgkin lymphoma (HL) is associated with poor prognosis. To determine the outcome for patients with early relapsed/refractory HL in the modern era, we combined data from two large transplant centres, Cleveland Clinic Taussig Cancer Institute (CCTCI) and Memorial Sloan-Kettering Cancer Center (MSKCC), and analysed consecutive patients transplanted for relapsed/refractory HL following induction failure or remission durations of < 1 year. Two hundred and fourteen patients were analysed and the event-free survival (EFS) and overall survival (OS) at 6 years for all patients were 45% and 55%, respectively. Factors significant for prognosis in multivariate analysis were extranodal disease and bulky disease (>= 5 cm). Patients with 0, 1, or 2 risk factors achieved 6 year EFS of 65%, 47%, and 24% and 6 year OS of 81%, 55%, and 27%, respectively. Patients with the sole risk factor of early relapsed/refractory disease achieved good outcomes in this large series; however the presence of bulk and/or extranodal disease significantly reduced EFS and OS. Patients with these additional risk factors are best suited for clinical trials investigating novel salvage regimens and post-transplant maintenance strategies.

• 出版日期2011-5