Risk factors predicting outcomes for primary refractory hodgkin lymphoma patients treated with salvage chemotherapy and autologous stem cell transplantation

Autor: Alison J. Moskowitz, Susan J. McCall, Joachim Yahalom, Matthew J. Matasar, Kurt S. Bantilan, Zhigang Zhang, Craig H. Moskowitz, Debra A. Goldman, Stephanie L. Verwys, Gunjan L. Shah
Rok vydání: 2016
Předmět:
Male
Oncology
medicine.medical_treatment
Salvage therapy
Hematopoietic stem cell transplantation
0302 clinical medicine
Autologous stem-cell transplantation
Risk Factors
Antineoplastic Combined Chemotherapy Protocols
Odds Ratio
Child
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Prognosis
Combined Modality Therapy
Hodgkin Disease
Treatment Outcome
B symptoms
Child
Preschool
030220 oncology & carcinogenesis
Retreatment
Female
medicine.symptom
Adult
medicine.medical_specialty
Adolescent
Transplantation
Autologous
Article
Young Adult
03 medical and health sciences
Refractory
Internal medicine
Refractory Hodgkin Lymphoma
medicine
Humans
Survival analysis
Aged
Neoplasm Staging
Retrospective Studies
Salvage Therapy
business.industry
Infant
Odds ratio
Survival Analysis
Surgery
Drug Resistance
Neoplasm
Positron-Emission Tomography
business
030215 immunology
Zdroj: British Journal of Haematology. 175:440-447
ISSN: 0007-1048
DOI: 10.1111/bjh.14245
Popis: We aimed to identify risk factors that predict functional imaging (FI) response to salvage chemotherapy and evaluate outcomes following autologous stem cell transplant (ASCT) in primary refractory Hodgkin Lymphoma (HL). From 1 October 1994 to 10 July 2015, 192 primary refractory HL patients were treated on sequential second line protocols. Event-free survival (EFS) and overall survival (OS) were calculated from the date of histological confirmation of refractory disease. Covariates were analysed for relationship with FI response and EFS. By intent-to-treat, the median EFS was 8·9 years and OS 10·4 years with 41% having positive post-salvage FI. On multivariate analysis, the presence of B symptoms and bulk ≥5 cm predicted for positive FI, with odds ratios of 2·15 and 2·03, respectively. For the 167 (87%) transplanted patients, 60% had a negative pre-ASCT FI. Median EFS and OS were not reached with at a median follow-up of 3·6 years in surviving patients. Both stage IV refractory disease and persistent FI abnormality pre- ASCT were associated with worse outcomes: 3-year EFS was 84%, 54% and 28% for zero, 1 and 2 risk factors, respectively (P
Databáze: OpenAIRE
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