title: Long-term outcomes after high dose therapy and autologous haematopoietic cell rescue for refractory/relapsed Hodgkin lymphoma.
abstract: The standard treatment for patients with refractory or relapsed Hodgkin lymphoma (HL) is high-dose chemotherapy and/or radiation with autologous haematopoietic cell rescue (AHCR). In this study, we assessed quality of life and evaluated the risk of late morbidity and mortality for HL patients who underwent AHCR. One hundred and fifty-four patients who underwent AHCR at Stanford University from 1988 to 2002 and survived ≥2 years were evaluated. Median follow-up was 10·2 years. There were 54 deaths, 34 from HL, 20 from other causes. The 10-year cumulative incidence of death from HL or other causes was 21·7% and 12·7%, respectively. Thirteen deaths were from second malignancies. The risk ratio of second malignancies was 8·0 [95% confidence interval (CI), 4·7-12·6] compared with the general population, and 3·0 (95% CI, 1·8-4·8) compared with HL patients not undergoing AHCR. The risk ratio of second malignancies was 1·5 (95% CI, 0·9-2·4) compared with HL patients receiving non-AHCR therapy. Overall quality of life did not differ from the general population, but AHCR survivors did note reduced functioning and some worse symptoms. AHCR survivors may be at increased risk of death from HL and other causes compared with the general population, but not compared with the HL population as a whole.
authors.affiliation: Department of Radiation Oncology, Stanford University, Palo Alto, CA, USA.
authors.forename: Ann Y
authors.initials: AY
authors.lastname: Minn
authors.forename: Elyn
authors.initials: E
authors.lastname: Riedel
authors.forename: Jerry
authors.initials: J
authors.lastname: Halpern
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Johnston
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Horning
authors.forename: Richard T
authors.initials: RT
authors.lastname: Hoppe
authors.forename: Karyn A
authors.initials: KA
authors.lastname: Goodman
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002423:Cause of Death; D002648:Child; 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; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000401:mortality; D011379:Prognosis; D011788:Quality of Life; D011879:Radiotherapy Dosage; D012306:Risk; D018426:SEER Program; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult