Progressive disease following autologous transplantation in patients with chemosensitive relapsed or primary refractory Hodgkin's disease or aggressive non-Hodgkin's lymphoma Journal Article


Authors: Kewalramani, T.; Nimer, S. D.; Zelenetz, A. D.; Malhotra, S.; Qin, J.; Yahalom, J.; Moskowitz, C. H.
Article Title: Progressive disease following autologous transplantation in patients with chemosensitive relapsed or primary refractory Hodgkin's disease or aggressive non-Hodgkin's lymphoma
Abstract: To determine the outcome of patients with chemosensitive relapsed or primary refractory Hodgkin's disease (HD) or aggressive non-Hodgkin's lymphoma (NHL) whose disease progresses after autologous stem cell transplantation (ASCT), we reviewed the records of 82 patients with HD and 139 patients with NHL transplanted between 1993 and 2000. Disease progression occurred in 25 patients with HD and 66 patients with NHL, with median times to progression (TTP) of 3.8 and 5.1 months, respectively. Median survival times following ASCT failure were 26 and 7.7 months for patients with HD and NHL, respectively. The second-line international prognostic index (sIPI) and the TTP (before or after 3 months from ASCT) independently were predictive of survival for NHL patients. In addition, treatment with rituximab for patients with B cell NHL was associated with improved survival (median 28.6 vs 4.1 months, P=0.003), independent of the sIPI and TTP. Prognostic factors for patients with HD were not identified. Only two patients, one of whom was among six patients who received second autologous transplants, remain disease-free. The uniformly poor outcome associated with disease progression after ASCT should prompt efforts to assess the feasibility and utility of detecting and treating post transplant residual disease during a minimal disease state, before overt progression.
Keywords: adolescent; adult; cancer survival; controlled study; treatment outcome; aged; disease-free survival; middle aged; survival rate; retrospective studies; major clinical study; disease course; cancer recurrence; salvage therapy; cancer radiotherapy; cytarabine; rituximab; carboplatin; etoposide; melphalan; hematopoietic stem cell transplantation; antineoplastic activity; chemosensitivity; carmustine; ifosfamide; hodgkin disease; b lymphocyte; monoclonal antibody; graft failure; nonhodgkin lymphoma; whole body radiation; feasibility study; drug mechanism; non-hodgkin's lymphoma; lymphoma, non-hodgkin; disease progression; graft versus host reaction; transplantation, autologous; autologous hematopoietic stem cell transplantation; progressive disease; autologous transplantation; hodgkin's disease; humans; prognosis; human; priority journal; article
Journal Title: Bone Marrow Transplantation
Volume: 32
Issue: 7
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2003-10-01
Start Page: 673
End Page: 679
Language: English
DOI: 10.1038/sj.bmt.1704214
PUBMED: 13130314
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Joachim Yahalom
    407 Yahalom
  2. Craig Moskowitz
    375 Moskowitz
  3. Jing Qin
    86 Qin
  4. Andrew D Zelenetz
    556 Zelenetz
  5. Stephen D Nimer
    345 Nimer