title: A prognostic model predicting autologous transplantation outcomes in children, adolescents and young adults with Hodgkin lymphoma.
abstract: Autologous hematopoietic cell transplantation (AutoHCT) is a potentially curative treatment modality for relapsed/refractory Hodgkin lymphoma (HL). However, no large studies have evaluated pretransplant factors predictive of outcomes of AutoHCT in children, adolescents and young adults (CAYA, age <30 years). In a retrospective study, we analyzed 606 CAYA patients (median age 23 years) with relapsed/refractory HL who underwent AutoHCT between 1995 and 2010. The probabilities of PFS at 1, 5 and 10 years were 66% (95% confidence interval (CI): 62-70), 52% (95% CI: 48-57) and 47% (95% CI: 42-51), respectively. Multivariate analysis for PFS demonstrated that at the time of AutoHCT patients with Karnofsky/Lansky score ⩾90, no extranodal involvement and chemosensitive disease had significantly improved PFS. Patients with time from diagnosis to first relapse of <1 year had a significantly inferior PFS. A prognostic model for PFS was developed that stratified patients into low-, intermediate- and high-risk groups, predicting for 5-year PFS probabilities of 72% (95% CI: 64-80), 53% (95% CI: 47-59) and 23% (95% CI: 9-36), respectively. This large study identifies a group of CAYA patients with relapsed/refractory HL who are at high risk of progression after AutoHCT. Such patients should be targeted for novel therapeutic and/or maintenance approaches post-AutoHCT.
authors.affiliation: Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.
authors.forename: P
authors.initials: P
authors.lastname: Satwani
authors.affiliation: CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA.|Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: K W
authors.initials: KW
authors.lastname: Ahn
authors.affiliation: CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: J
authors.initials: J
authors.lastname: Carreras
authors.affiliation: Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Abdel-Azim
authors.affiliation: Pediatric Hematology/Oncology and Stem Cell Transplantation, New York Medical College, New York, NY, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Cairo
authors.affiliation: Division of Oncology, Washington University School of Medicine, St Louis, MO, USA.
authors.forename: A
authors.initials: A
authors.lastname: Cashen
authors.affiliation: Oregon Health and Science University, Portland, OR, USA.
authors.forename: A I
authors.initials: AI
authors.lastname: Chen
authors.affiliation: Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Cohen
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Costa
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: C
authors.initials: C
authors.lastname: Dandoy
authors.affiliation: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: T S
authors.initials: TS
authors.lastname: Fenske
authors.affiliation: South Texas Veterans Health Care System and University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: C O
authors.initials: CO
authors.lastname: Freytes
authors.affiliation: Blood and Marrow Transplantation, Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: S
authors.initials: S
authors.lastname: Ganguly
authors.affiliation: Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK.
authors.forename: R P
authors.initials: RP
authors.lastname: Gale
authors.affiliation: Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC, USA.
authors.forename: N
authors.initials: N
authors.lastname: Ghosh
authors.affiliation: Department of Haematology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: M S
authors.initials: MS
authors.lastname: Hertzberg
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, MO, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Hayashi
authors.affiliation: Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: Kamble
authors.affiliation: Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, WV, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Kanate
authors.affiliation: Department of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Keating
authors.affiliation: Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Kharfan-Dabaja
authors.affiliation: Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Lazarus
authors.affiliation: Pediatric Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, UK.
authors.forename: D I
authors.initials: DI
authors.lastname: Marks
authors.affiliation: Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: T
authors.initials: T
authors.lastname: Nishihori
authors.affiliation: Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.|Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
authors.forename: R F
authors.initials: RF
authors.lastname: Olsson
authors.affiliation: Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand.
authors.forename: T D
authors.initials: TD
authors.lastname: Prestidge
authors.affiliation: Bone Marrow Transplante Unit, FUNDALEU, Buenos Aires, Argentina.
authors.forename: J M
authors.initials: JM
authors.lastname: Rolon
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: B N
authors.initials: BN
authors.lastname: Savani
authors.affiliation: Department of Internal Medicine, The Nebraska Medical Center, Omaha, NE, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Vose
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: W A
authors.initials: WA
authors.lastname: Wood
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Inwards
authors.affiliation: Bone and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN, USA.
authors.forename: V
authors.initials: V
authors.lastname: Bachanova
authors.affiliation: Section of Hematology/Oncology, The University of Chicago, Chicago, IL, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Smith
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Maloney
authors.affiliation: Servei d'Hematologia, Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sureda
authors.affiliation: CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hamadani
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016879:Salvage Therapy; D014182:Transplantation, Autologous; D055815:Young Adult