Survival analysis of patients with Hodgkin lymphoma who failed high dose chemotherapy and autologous stem cell transplant

AbstractHodgkin lymphoma (HL) patients failing after high dose chemotherapy (HDC) and auto-SCT have a poor outcome. Some patients may still benefit from further treatments. From 1996 to 2016, 137 HL patients (39.5%) out of 347 transplanted experienced post auto-SCT failure. Males/female 61%:39%, median age at auto-SCT 23.4  years and median follow-up 55.6 months (9–153). Type of failure was progressive (46%), relapsed (35%) or persistent disease/refractory disease (19%). Median overall survival (OS) from the time of failure is 20 months; 35 patients (25.5%) are alive. One hundred and four patients received treatm ent; the response rate was 45%; complete remission in 41 (30%) and partial remission in 21 (15%) patients. 1st interventions post auto-SCT were chemotherapy (39%), radiation therapy (35%) or best supportive care (24%). Twenty-seven patients with 2nd-SCT (allogeneic (15), auto-SCT (2)) and/or brentux imab (18 patients) had superior OS (50.6 months) vs other treatments (22.5 months,P value 0.037). COX regression multivariate analysis identified post auto-SCT treatment failure before 12  months (hazard ratio (HR) 3.37, CI 1.7–6.6,P value<  0.001), presence of B symptoms (HR 2.55, CI 1.4–4.6,P value 0.002), stages III –IV (HR 2.7, CI 1.5–4.9,P value 0.001), albumin<  4 g/dl (HR 1.76, CI 1.1–2.9,P value 0.027) and tumor>  5 cm (HR 1.1.9, CI 1.13–3.25,P value 0.015) as significant risk factors;P value<  0.001. KM OS with 0–1 fact...
Source: Annals of Hematology - Category: Hematology Source Type: research