Popis: |
High dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) is suggested as the standard of treatment of patients with relapsed or refractory Hodgkin’s lymphoma (HL) providing long-term disease-free survival in over 50 % of patients. The insufficient number of Russian medical centers, which can provide HDCT with ASCT, result into a broken chain of treatment. The main goal of this thesis is the evaluation of a timely mannered qualified medical help as potential independent prognosis factor. Our study included data of patients with refractory or relapsed HL who underwent treatment between 2013 and 2017 in our Center. Due to our data the negative prognostic factors affecting progression-free survival are: primary refractory disease (60 % vs 94 %; HR 2,1 [95 % CI 1.20-3.56], p=0.041); response for the 1st line of salvage therapy less than complete remission (CR) (35 % vs 91 %; HR 2,4 [95 % CI 1.81-3.24], p=0.022), presence of chain treatment disruption (41 % vs 90 %; HR 2,9 [95 % CI 2.43-4.2], p=0.029), disease status less than CR prior ASCT (29 % vs 87 %; HR 4,3 [95 % CI 2.9-6.1], p=0.009). Our results demonstrate that timely mannered qualified medical care is a key component that improves the survival of patients with relapses and refractory forms of Hodgkin’s lymphoma. |