Autologous stem cell transplant for early relapsed/refractory Hodgkin lymphoma: Results from two transplant centres Journal Article

Authors: Smith, S. D.; Moskowitz, C. H.; Dean, R.; Pohlman, B.; Sobecks, R.; Copelan, E.; Andresen, S.; Bolwell, B.; Maragulia, J. C.; Vanak, J. M.; Sweetenham, J.; Moskowitz, A. J.
Article Title: Autologous stem cell transplant for early relapsed/refractory Hodgkin lymphoma: Results from two transplant centres
Abstract: Prior series have demonstrated that early relapsed (within 1year) 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 <1year. Two hundred and fourteen patients were analysed and the event-free survival (EFS) and overall survival (OS) at 6years for all patients were 45% and 55%, respectively. Factors significant for prognosis in multivariate analysis were extranodal disease and bulky disease (≥5cm). Patients with 0, 1, or 2 risk factors achieved 6year EFS of 65%, 47%, and 24% and 6year 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. © 2011 Blackwell Publishing Ltd.
Keywords: adolescent; adult; cancer survival; controlled study; event free survival; treatment response; aged; survival rate; human cell; major clinical study; overall survival; busulfan; prednisone; salvage therapy; cisplatin; doxorubicin; risk benefit analysis; gemcitabine; cytarabine; drug megadose; antineoplastic agent; carboplatin; dacarbazine; multiple cycle treatment; etoposide; relapse; cyclophosphamide; dexamethasone; vincristine; autologous stem cell transplantation; stem cell transplantation; continuous infusion; risk factor; carmustine; chlormethine; ifosfamide; procarbazine; vinblastine; high risk patient; hodgkin disease; survival time; cancer regression; cancer size; bleomycin; cancer relapse; methylprednisolone; pancytopenia; granulocyte colony stimulating factor; hodgkin lymphoma; refractory
Journal Title: British Journal of Haematology
Volume: 153
Issue: 3
ISSN: 0007-1048
Publisher: John Wiley & Sons  
Date Published: 2011-05-01
Start Page: 358
End Page: 363
Language: English
DOI: 10.1111/j.1365-2141.2011.08616.x
PROVIDER: scopus
PUBMED: 21410449
Notes: --- - "Export Date: 23 June 2011" - "CODEN: BJHEA" - "Source: Scopus"
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MSK Authors
  1. Craig Moskowitz
    375 Moskowitz
  2. Alison Moskowitz
    148 Moskowitz
  3. Jill M Vanak
    14 Vanak