title: High-dose chemotherapy followed by autologous stem cell transplantation for relapsed or refractory Hodgkin lymphoma: prognostic features and outcomes.
abstract: Between January 1990 and April 2001, 115 patients received high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) for relapsed or refractory Hodgkin lymphoma (HL). With a median follow-up of 58 months (range, 1 - 175 months), 5-year progression-free survival (PFS) and overall survival (OS) were 46% and 58%, respectively. Twelve patients with primary refractory disease had a 5-year PFS of 41% and OS of 58%, not significantly different from those of the remaining cohort. Early and overall regimen related mortality were 7% and 16%, respectively. Male gender (P = 0.04) and a time to relapse (TTR) < 12 months (P = 0.03) were associated with decreased OS by univariate analysis. In multivariate analysis, TTR < 12 months remained statistically significant (P = 0.04). We have confirmed that HDT and ASCT result in long-term survival for a proportion of patients with relapsed or refractory HL. All patients, including those with primary refractory disease, benefited from HDT and ASCT.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Engelhardt
authors.forename: Derek W
authors.initials: DW
authors.lastname: Holland
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Brandt
authors.forename: Wichai
authors.initials: W
authors.lastname: Chinratanalab
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Goodman
authors.forename: John P
authors.initials: JP
authors.lastname: Greer
authors.forename: Madan H
authors.initials: MH
authors.lastname: Jagasia
authors.forename: Adetola A
authors.initials: AA
authors.lastname: Kassim
authors.forename: David S
authors.initials: DS
authors.lastname: Morgan
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Ruffner
authors.forename: Friedrich G
authors.initials: FG
authors.lastname: Schuening
authors.forename: Steven
authors.initials: S
authors.lastname: Wolff
authors.forename: Rhonda
authors.initials: R
authors.lastname: Bitting
authors.forename: Paulgun
authors.initials: P
authors.lastname: Sulur
authors.forename: Richard S
authors.initials: RS
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000209:etiology; D011379:Prognosis; D012008:Recurrence; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome