title: Autologous hematopoietic stem cell transplantation in classical Hodgkin's lymphoma.
abstract: BACKGROUND
  Hodgkin's lymphoma has high rates of cure, but in 15% to 20% of general patients and between 35% and 40% of those in advanced stages, the disease will progress or will relapse after initial treatment. For this group, hematopoietic stem cell transplantation is considered one option of salvage therapy.
  
  
  OBJECTIVE
  To evaluate a group of 106 patients with Hodgkin's lymphoma, who suffered relapse or who were refractory to treatment, submitted to autologous hematopoietic stem cell transplantation in a single transplant center.
  
  
  METHODS
  A retrospective study was performed with data collected from patient charts. The analysis involved 106 classical Hodgkin's lymphoma patients who were consecutively submitted to high-dose chemotherapy followed by autologous transplants in a single institution from April 1993 to December 2006.
  
  
  RESULTS
  The overall survival rates of this population at five and ten years were 86% and 70%, respectively. The disease-free survival was approximately 60% at five years. Four patients died of procedure-related causes but relapse of classical Hodgkin's lymphoma after transplant was the most frequent cause of death. Univariate analysis shows that sensitivity to pre-transplant treatment and hemoglobin < 10 g/dL at diagnosis had an impact on patient survival. Unlike other studies, B-type symptoms did not seem to affect overall survival. Lactic dehydrogenase and serum albumin concentrations analyzed at diagnosis did not influence patient survival either.
  
  
  CONCLUSIONS
  Autologous hematopoietic stem cell transplantation is an effective treatment strategy for early and late relapse in classical Hodgkin's lymphoma for cases that were responsive to pre-transplant chemotherapy. Refractory to treatment is a sign of worse prognosis. Additionally, a hemoglobin concentration below 10 g/dL at diagnosis of Hodgkin's lymphoma has a negative impact on the survival of patients after transplant. As far as we know this relationship has not been previously reported.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo - USP, São Paulo (SP), Brazil.
authors.forename: Afonso José Pereira
authors.initials: AJ
authors.lastname: Cortez
authors.forename: Frederico Luiz
authors.initials: FL
authors.lastname: Dulley
authors.forename: Rosaura
authors.initials: R
authors.lastname: Saboya
authors.forename: Alfredo
authors.initials: A
authors.lastname: Mendrone Júnior
authors.forename: Ulisses
authors.initials: U
authors.lastname: Amigo Filho
authors.forename: Fabio Luiz
authors.initials: FL
authors.lastname: Coracin
authors.forename: Valéria
authors.initials: V
authors.lastname: Buccheri
authors.forename: Camila da Cruz Gouveia
authors.initials: Cda C
authors.lastname: Linardi
authors.forename: Milton Artur
authors.initials: MA
authors.lastname: Ruiz
authors.forename: Dalton de Alencar Fischer
authors.initials: Dde A
authors.lastname: Chamone
keywords: Autologous transplantation; Bleomycynm; Dacarbazine; Doxorubicin; Hematopoietic stem cell transplantation; Hodgkin's lymphoma; Study retrospective; Vinblastine