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Prognostic factors and long-term outcome of autologous haematopoietic stem cell transplantation following a uniform-modified BEAM-conditioning regimen for patients with refractory or relapsed Hodgkin lymphoma: a single-center experience.

Czyz A, Lojko-Dankowska A, Dytfeld D, Nowicki A, Gil L, Matuszak M, Kozlowska-Skrzypczak M, Kazmierczak M, Bembnista E, Komarnicki M - Med. Oncol. (2013)

Bottom Line: The median PFS for patients with >1 risk factor in the relapsed and refractory setting was 5 and 11 months, respectively, in comparison with the median PFS not reached for patients with 0-1 risk factor in both settings.We conclude that high proportion of patients with relapsed/refractory HL can be cured with autoHCT.However, the presence of two or more risk factors helps to identify poor prognosis patients who may benefit from novel treatment strategies.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, Poznan University of Medical Sciences, Szamarzewskiego 84, 61-569 Poznan, Poland. aczyz@onet.eu

ABSTRACT
Despite the well-defined role of autologous haematopoietic stem cell transplantation (autoHCT) in the treatment of patients with relapsed or refractory Hodgkin lymphoma (HL), relapse remains the main cause of transplant failure. We retrospectively evaluated long-term outcome and prognostic factors affecting survival of 132 patients with refractory (n = 89) or relapsed HL (n = 43) treated with autoHCT following modified BEAM. With a median follow-up of 68 months, the 10-year overall survival (OS) and progression-free survival (PFS) were 76 and 66 %, respectively. The 10-year cumulative incidence of second malignancies was 7 %. In multivariate analysis, age ≥45 years, more than one salvage regimens and disease status at transplant worse than CR were factors predictive for poor OS. In relapsed HL, age at transplant, response duration (<12 vs. ≥12 months) and the number of salvage regimens were independent predictors for PFS. In the refractory setting, disease status at autoHCT and the number of salvage regimens impacted PFS. The number of risk factors was inversely correlated with PFS in both relapsed and refractory HL (p = 0.003 and <0.001, respectively). The median PFS for patients with >1 risk factor in the relapsed and refractory setting was 5 and 11 months, respectively, in comparison with the median PFS not reached for patients with 0-1 risk factor in both settings. We conclude that high proportion of patients with relapsed/refractory HL can be cured with autoHCT. However, the presence of two or more risk factors helps to identify poor prognosis patients who may benefit from novel treatment strategies.

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Related in: MedlinePlus

Kaplan–Meier estimates of overall survival (OS) and progression-free survival (PFS) for the whole study group
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Fig1: Kaplan–Meier estimates of overall survival (OS) and progression-free survival (PFS) for the whole study group

Mentions: The median follow-up time of surviving patients is 68 months (range 10–139 months). Figure 1 illustrates the Kaplan–Meier survival curves for the whole study group. At 5 and 10 years after transplantation, estimated OS was 77.0 % (95 % CI 68.3–83.9 %) and 75.6 % (95 % CI 66.8–82.7 %), respectively. The respective PFS rates were 69.1 % (95 % CI 60.3–76.5 %) and 65.6 % (95 % CI 55.9–74.0 %) (Fig. 1).Fig. 1


Prognostic factors and long-term outcome of autologous haematopoietic stem cell transplantation following a uniform-modified BEAM-conditioning regimen for patients with refractory or relapsed Hodgkin lymphoma: a single-center experience.

Czyz A, Lojko-Dankowska A, Dytfeld D, Nowicki A, Gil L, Matuszak M, Kozlowska-Skrzypczak M, Kazmierczak M, Bembnista E, Komarnicki M - Med. Oncol. (2013)

Kaplan–Meier estimates of overall survival (OS) and progression-free survival (PFS) for the whole study group
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3755217&req=5

Fig1: Kaplan–Meier estimates of overall survival (OS) and progression-free survival (PFS) for the whole study group
Mentions: The median follow-up time of surviving patients is 68 months (range 10–139 months). Figure 1 illustrates the Kaplan–Meier survival curves for the whole study group. At 5 and 10 years after transplantation, estimated OS was 77.0 % (95 % CI 68.3–83.9 %) and 75.6 % (95 % CI 66.8–82.7 %), respectively. The respective PFS rates were 69.1 % (95 % CI 60.3–76.5 %) and 65.6 % (95 % CI 55.9–74.0 %) (Fig. 1).Fig. 1

Bottom Line: The median PFS for patients with >1 risk factor in the relapsed and refractory setting was 5 and 11 months, respectively, in comparison with the median PFS not reached for patients with 0-1 risk factor in both settings.We conclude that high proportion of patients with relapsed/refractory HL can be cured with autoHCT.However, the presence of two or more risk factors helps to identify poor prognosis patients who may benefit from novel treatment strategies.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, Poznan University of Medical Sciences, Szamarzewskiego 84, 61-569 Poznan, Poland. aczyz@onet.eu

ABSTRACT
Despite the well-defined role of autologous haematopoietic stem cell transplantation (autoHCT) in the treatment of patients with relapsed or refractory Hodgkin lymphoma (HL), relapse remains the main cause of transplant failure. We retrospectively evaluated long-term outcome and prognostic factors affecting survival of 132 patients with refractory (n = 89) or relapsed HL (n = 43) treated with autoHCT following modified BEAM. With a median follow-up of 68 months, the 10-year overall survival (OS) and progression-free survival (PFS) were 76 and 66 %, respectively. The 10-year cumulative incidence of second malignancies was 7 %. In multivariate analysis, age ≥45 years, more than one salvage regimens and disease status at transplant worse than CR were factors predictive for poor OS. In relapsed HL, age at transplant, response duration (<12 vs. ≥12 months) and the number of salvage regimens were independent predictors for PFS. In the refractory setting, disease status at autoHCT and the number of salvage regimens impacted PFS. The number of risk factors was inversely correlated with PFS in both relapsed and refractory HL (p = 0.003 and <0.001, respectively). The median PFS for patients with >1 risk factor in the relapsed and refractory setting was 5 and 11 months, respectively, in comparison with the median PFS not reached for patients with 0-1 risk factor in both settings. We conclude that high proportion of patients with relapsed/refractory HL can be cured with autoHCT. However, the presence of two or more risk factors helps to identify poor prognosis patients who may benefit from novel treatment strategies.

Show MeSH
Related in: MedlinePlus