Risk factors predicting outcomes for primary refractory Hodgkin lymphoma patients treated with salvage chemotherapy and autologous stem cell transplantation Journal Article


Authors: Shah, G. L.; Yahalom, J.; Matasar, M. J.; Verwys, S. L.; Goldman, D. A.; Bantilan, K. S.; Zhang, Z.; McCall, S. J.; Moskowitz, A. J.; Moskowitz, C. H.
Article Title: Risk factors predicting outcomes for primary refractory Hodgkin lymphoma patients treated with salvage chemotherapy and autologous stem cell transplantation
Abstract: We aimed to identify risk factors that predict functional imaging (FI) response to salvage chemotherapy and evaluate outcomes following autologous stem cell transplant (ASCT) in primary refractory Hodgkin Lymphoma (HL). From 1 October 1994 to 10 July 2015, 192 primary refractory HL patients were treated on sequential second line protocols. Event-free survival (EFS) and overall survival (OS) were calculated from the date of histological confirmation of refractory disease. Covariates were analysed for relationship with FI response and EFS. By intent-to-treat, the median EFS was 8·9 years and OS 10·4 years with 41% having positive post-salvage FI. On multivariate analysis, the presence of B symptoms and bulk ≥5 cm predicted for positive FI, with odds ratios of 2·15 and 2·03, respectively. For the 167 (87%) transplanted patients, 60% had a negative pre-ASCT FI. Median EFS and OS were not reached with at a median follow-up of 3·6 years in surviving patients. Both stage IV refractory disease and persistent FI abnormality pre- ASCT were associated with worse outcomes: 3-year EFS was 84%, 54% and 28% for zero, 1 and 2 risk factors, respectively (P < 0·001). Further studies are needed to validate our prognostic model and to determine optimal therapy for patients with multiple risk factors. © 2016 John Wiley & Sons Ltd
Keywords: positron emission tomography; hodgkin lymphoma; autologous stem cell transplant; primary refractory
Journal Title: British Journal of Haematology
Volume: 175
Issue: 3
ISSN: 0007-1048
Publisher: John Wiley & Sons  
Date Published: 2016-11-01
Start Page: 440
End Page: 447
Language: English
DOI: 10.1111/bjh.14245
PROVIDER: scopus
PUBMED: 27377168
PMCID: PMC5554509
DOI/URL:
Notes: Article -- Export Date: 6 December 2016 -- Source: Scopus
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MSK Authors
  1. Zhigang Zhang
    241 Zhang
  2. Joachim Yahalom
    404 Yahalom
  3. Craig Moskowitz
    374 Moskowitz
  4. Alison Moskowitz
    147 Moskowitz
  5. Matthew J Matasar
    121 Matasar
  6. Susan J McCall
    14 McCall
  7. Debra Alyssa Goldman
    94 Goldman
  8. Gunjan Lalitchandra Shah
    81 Shah
  9. Stephanie Lisl Verwys
    4 Verwys