A long-term experience using autologous stem cell transplantation for the managment of Hodgkin's lymphoma

B. Skikne, C. Divine, N. Thudi, D. Deauna-Limayo, D. Bodensteiner, S. Ganguly, C. Williams, S. Abhyankar, J. McGuirk
2006 Biology of Blood and Marrow Transplantation  
patients and 201 weeks for SCR patients. Factors differentiating the BuMelTT and SCR groups included median followup post-ASCT, total percent relapse after transplant, death after transplant, relapse in prior radiation field, and stage at salvage therapy pre-ASCT. To date, 37% of the BuMelTT and 56% of SCR patients have relapsed (P Ͻ .05) with a median time to relapse of 30 and 36 weeks (P ϭ NS), respectively. Median OS, EFS, and RFS have not yet been reached for BuMelTT patients compared with
more » ... ents compared with 439 (P ϭ .03), 67 (P ϭ NS), and 74 (P ϭ NS) weeks for the SCR patients respectively. TRM was 5% in both groups at 5 years. Secondary myelodysplasia has been seen in one patient transplanted with BuMelTT and one with SCR. In multivariate analysis the BuMelTT regimen and chemosensitive disease were associated with improved OS (HR ϭ 0.19 and 0.31, respectively). Relapse in prior radiation field predicted for poor EFS and OS (HR ϭ 3.43). We investigated the predictive value of 4 PM on the entire group, BuMelTT and SCR cohorts. Each of these models has identified 3 poor prognostic indicators on the basis of multivariate analysis. Patients with 0 or 1 factor were considered good risk and 2 or 3 factors poor risk. Only the SWOG model was predictive for OS for the entire group (P Ͻ .01) and for the BuMelTT (Pϭ0.05) and SCR (P Ͻ .01) cohorts. The SWOG model was also able to differentiate EFS between good and poor risk patients for the entire group (P ϭ .02) and SCR group (P ϭ .05) but not for the BuMelTT cohort. None of the models could differentiate between good and poor risk patients with regard to RFS. When good and poor risk was defined as 0 factors versus 1 to 3 factors, the RPCI model was predictive of OS (P ϭ .02) and EFS (P ϭ .02) but only for the BuMelTT cohort. The PM evaluated had limited utility in our patient cohort with only the SWOG model being predictive of outcome. Large multi-institutional studies are needed to improve PM for transplantation in advanced HD.
doi:10.1016/j.bbmt.2005.11.295 fatcat:m6jz4w6ivrgghiycbljp3uouma