Outcome of autologous hematopoietic stem cell transplantation in children and adolescents with relapsed or refractory Hodgkin's lymphoma.
This study evaluates the outcome of 66 pediatric patients with rrHL who underwent autoHSCT. Twenty-nine patients experienced early relapse, and 19 patients experienced late relapse. Of 18 newly diagnosed with HL, 13 were primary refractory disease and five had late responsive disease. At the time of transplantation, only 68% of the patients were chemosensitive. The majority of patients received BCNU + etoposide + ara-C + melphalan for conditioning (45/66), and peripheral blood (56/66) was used as a source of stem cells. After a median follow-up period of 39 months, 46 patients were alive. At five yr, the probabilities of OS, EFS, the relapse rate, and the non-relapse mortality rate were 63.1%, 54.3%, 36.4%, and 9.1%, respectively. The probability of EFS in chemosensitive and chemoresistant patients at five yr was 72.3% and 19%, respectively (p < 0.001). Multivariate analysis showed that chemoresistant disease at the time of transplantation was the only factor predicting limited both OS (hazard ratio = 4.073) and EFS (hazard ratio = 4.599). AutoHSCT plays an important role for the treatment of rrHL in children and adolescents, and survival rates are better for patients with chemosensitive disease at the time of transplantation.
Pediatric BMT Units, Medipol University Faculty of Medicine, Istanbul, Turkey.
Volkan
V
Hazar
Pediatric BMT Units, Gulhane Military Medical Academy, Ankara, Turkey.
Vural
V
Kesik
Pediatric BMT Units, Ege University Faculty of Medicine, Izmir, Turkey.
Serap
S
Aksoylar
Pediatric BMT Units, Erciyes University Faculty of Medicine, Kayseri, Turkey.
Musa
M
Karakukcu
Pediatric BMT Units, Medical Park Bahcelievler Hospital, İstanbul, Turkey.
Gulyuz
G
Ozturk
Pediatric BMT Units, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Alphan
A
Kupesiz
Pediatric BMT Units, Gulhane Military Medical Academy, Ankara, Turkey.
Erman
E
Atas
Pediatric BMT Units, Tepecik Hospital, İzmir, Turkey.
Haldun
H
Oniz
Pediatric BMT Units, Ege University Faculty of Medicine, Izmir, Turkey.
Savas
S
Kansoy
Pediatric BMT Units, Erciyes University Faculty of Medicine, Kayseri, Turkey.
Ekrem
E
Unal
Pediatric BMT Units, Cukurova University Faculty of Medicine, Adana, Turkey.
Atila
A
Tanyeli
Pediatric BMT Units, Medical Park Bahcelievler Hospital, İstanbul, Turkey.
Fatih
F
Erbey
Pediatric BMT Units, On Dokuz Mayis University Faculty of Medicine, Samsun, Turkey.
Murat
M
Elli
Pediatric BMT Units, Ankara University Faculty of Medicine, Ankara, Turkey.
Nurdan
N
Tacyildiz
Pediatric BMT Units, Bahcesehir University Faculty of Medicine Medical Park Goztepe Hospital, Istanbul, Turkey.
Gulsun Tezcan
GT
Karasu
Pediatric BMT Units, Gazi University Faculty of Medicine, Ankara, Turkey.
Ulker
U
Kocak
Pediatric BMT Units, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.
Sema
S
Anak
Pediatric BMT Units, Bahcesehir University Faculty of Medicine, Medical Park Antalya Hospital, Antalya, Turkey.
Sebnem
S
Yilmaz Bengoa
Pediatric BMT Units, Cukurova University Faculty of Medicine, Adana, Turkey.
Gulay
G
Sezgin
Pediatric BMT Units, Medical Park Bahcelievler Hospital, İstanbul, Turkey.
Didem
D
Atay
Pediatric BMT Units, Ankara University Faculty of Medicine, Ankara, Turkey.
Emel
E
Unal
Pediatric BMT Units, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Vedat
V
Uygun
Pediatric BMT Units, Ankara Oncology Hospital, Ankara, Turkey.
Nilgun
N
Kurucu
Pediatric BMT Units, Gazi University Faculty of Medicine, Ankara, Turkey.
Zuhre
Z
Kaya
Pediatric BMT Units, Bahcesehir University Faculty of Medicine Medical Park Goztepe Hospital, Istanbul, Turkey.
Akif
A
Yesilipek
D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
Hodgkin's lymphoma; autologous hematopoietic stem cell transplantation; children and adolescents; refractory; relapse; survival