title: Prognostic factors affecting long-term outcome after stem cell transplantation in Hodgkin's lymphoma autografted after a first relapse.
abstract: OBJECTIVE
  To analyse outcome and prognostic factors for overall survival (OS) and time to treatment failure (TTF) in 357 patients with Hodgkin's lymphoma (HL) undergoing an autologous stem cell transplantation (ASCT) after a first relapse and reported to the The Grupo Espanol de Linfomas/Trasplante Autologo de Medula Osea (GEL/TAMO) Cooperative Group.
  
  
  METHODS
  Two hundred and twenty males and 137 females with a median age of 29 years were autografted in second remission (n=181), first sensitive relapse (n=148) and first resistant relapse (n=28).
  
  
  RESULTS
  Five-year actuarial TTF and OS were of 49% +/- 3% and 57% +/- 3%. Advanced stage at diagnosis, complementary radiotherapy before ASCT, a short first complete response (CR) and detectable disease at ASCT adversely influenced TTF. Year of transplant < or =1995, bulky disease at diagnosis, a short first CR, detectable disease at ASCT and > or =1 extranodal areas involved at ASCT were adverse factors for OS.
  
  
  CONCLUSIONS
  ASCT constitutes a therapeutic option for HL patients after a first relapse. Promising results are observed in patients with low tumour burden at diagnosis, autografted after a long CR and without detectable disease at ASCT. Innovative approaches should be pursued for patients with risk factors at relapse.
authors.affiliation: Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Antoni Maria i Claret, 167, 08025 Barcelona, Spain. asureda@hsp.santpau.es
authors.forename: A
authors.initials: A
authors.lastname: Sureda
authors.forename: M
authors.initials: M
authors.lastname: Constans
authors.forename: A
authors.initials: A
authors.lastname: Iriondo
authors.forename: R
authors.initials: R
authors.lastname: Arranz
authors.forename: M D
authors.initials: MD
authors.lastname: Caballero
authors.forename: M J
authors.initials: MJ
authors.lastname: Vidal
authors.forename: J
authors.initials: J
authors.lastname: Petit
authors.forename: A
authors.initials: A
authors.lastname: López
authors.forename: J J
authors.initials: JJ
authors.lastname: Lahuerta
authors.forename: E
authors.initials: E
authors.lastname: Carreras
authors.forename: J
authors.initials: J
authors.lastname: García-Conde
authors.forename: J
authors.initials: J
authors.lastname: García-Laraña
authors.forename: R
authors.initials: R
authors.lastname: Cabrera
authors.forename: I
authors.initials: I
authors.lastname: Jarque
authors.forename: D
authors.initials: D
authors.lastname: Carrera
authors.forename: J C
authors.initials: JC
authors.lastname: García-Ruiz
authors.forename: M J
authors.initials: MJ
authors.lastname: Pascual
authors.forename: J
authors.initials: J
authors.lastname: Rifón
authors.forename: J M
authors.initials: JM
authors.lastname: Moraleda
authors.forename: K
authors.initials: K
authors.lastname: Pérez-Equiza
authors.forename: C
authors.initials: C
authors.lastname: Albó
authors.forename: J
authors.initials: J
authors.lastname: Díaz-Mediavilla
authors.forename: A
authors.initials: A
authors.lastname: Torres
authors.forename: P
authors.initials: P
authors.lastname: Torres
authors.forename: J
authors.initials: J
authors.lastname: Besalduch
authors.forename: J
authors.initials: J
authors.lastname: Marín
authors.forename: M V
authors.initials: MV
authors.lastname: Mateos
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Rañada
authors.forename: J
authors.initials: J
authors.lastname: Sierra
authors.forename: E
authors.initials: E
authors.lastname: Conde
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011379:Prognosis; D033581:Stem Cell Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D013995:Time; D014182:Transplantation, Autologous; D016896:Treatment Outcome