Outcomes for patients who fail high dose chemoradiotherapy and autologous stem cell rescue for relapsed and primary refractory Hodgkin lymphoma Journal Article


Authors: Moskowitz, A. J.; Perales, M. A.; Kewalramani, T.; Yahalom, J.; Castro-Malaspina, H.; Zhang, Z.; Vanak, J.; Zelenetz, A. D.; Moskowitz, C. H.
Article Title: Outcomes for patients who fail high dose chemoradiotherapy and autologous stem cell rescue for relapsed and primary refractory Hodgkin lymphoma
Abstract: Most patients with Hodgkin lymphoma (HL) are cured with first and second-line treatment; however, the outcome is unknown for those who fail high dose chemoradiotherapy with autologous stem cell transplant (HDT-ASCT). This report is an analysis of patients with relapsed and primary refractory HL who were treated with HDT-ASCT and failed due to progression of disease (POD). Two hundred and two patients received HDT-ASCT at Memorial Sloan Kettering Cancer Center for relapsed or refractory HL between December 1994 and 2005 and 71 failed due to POD. The median survival following HDT-ASCT failure was 25 months. Only 16 (23%) of the 71 patients are currently alive, nine of whom are in remission. Multivariate analysis revealed two factors associated with poor outcome: relapse within 6 months of HDT-ASCT and primary refractory disease. The only factor associated with improved survival was the ability to receive a second transplant, in particular, reduced intensity allogeneic transplant (RIT). Novel therapies are needed for patients who fail HDT-ASCT, particularly those with primary refractory disease and those who relapse within 6 months of HDT-ASCT. Future studies should focus on prospectively evaluating RIT following HDT-ASCT failure in patients with remission duration from HDT-ASCT of >6 months. © 2009 Blackwell Publishing Ltd.
Keywords: adolescent; adult; cancer survival; treatment outcome; aged; major clinical study; prednisone; doxorubicin; cancer growth; gemcitabine; carboplatin; etoposide; relapse; vincristine; autologous stem cell transplantation; transplantation; chlormethine; ifosfamide; procarbazine; hodgkin disease; cancer regression; cancer relapse; navelbine; autologous stem cell transplant; hodgkins lymphoma; reduced intensity transplant
Journal Title: British Journal of Haematology
Volume: 146
Issue: 2
ISSN: 0007-1048
Publisher: John Wiley & Sons  
Date Published: 2009-07-01
Start Page: 158
End Page: 163
Language: English
DOI: 10.1111/j.1365-2141.2009.07727.x
PROVIDER: scopus
PUBMED: 19438504
PMCID: PMC3278667
DOI/URL:
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 30 November 2010" - "CODEN: BJHEA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Zhigang Zhang
    244 Zhang
  2. Joachim Yahalom
    407 Yahalom
  3. Craig Moskowitz
    375 Moskowitz
  4. Andrew D Zelenetz
    556 Zelenetz
  5. Miguel-Angel Perales
    382 Perales
  6. Alison Moskowitz
    148 Moskowitz
  7. Jill M Vanak
    14 Vanak