Second autologous stem cell transplantation for relapsed/refractory Hodgkin lymphoma after a previous autograft: a study of the lymphoma working party of the EBMT

Leuk Lymphoma. 2020 Dec;61(12):2915-2922. doi: 10.1080/10428194.2020.1789624. Epub 2020 Jul 11.

Abstract

The purpose of this study was to analyze the results of second autologous hematopoietic stem cell transplantation (ASCT2) for patients with relapsed/refractory Hodgkin lymphoma (HL) after a first transplantation (ASCT1). Outcomes for 56 patients receiving an ASCT2 registered in the EBMT database were analyzed. The 4-year cumulative incidences of non-relapse mortality and disease relapse/progression were 5% and 67%, respectively. The 4-year overall survival (OS) and progression-free survival (PFS) were 62% and 28%. In univariate analysis, relapse of HL within 12 months of ASCT1 was associated with a worse OS (35% versus 76%, p = 0.01) and PFS (19% versus 29%, p = 0.059). Chemosensitivity at ASCT2 predicted better outcomes (4-year OS 72% versus 29%, p = 0.002; PFS 31% versus 12%, p = 0.015). This series shows that ASCT2 is a safe procedure and a relatively effective option for patients with late relapses after ASCT1 and with chemosensitive disease who are not eligible for an allogeneic transplant.

Keywords: Hodgkin lymphoma; autologous hematopoietic stem cell transplantation; refractory; relapse.

MeSH terms

  • Autografts
  • Disease-Free Survival
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hodgkin Disease* / therapy
  • Humans
  • Lymphoma*
  • Neoplasm Recurrence, Local
  • Recurrence
  • Stem Cell Transplantation
  • Transplantation, Autologous