Prognostic Factors and a New Prognostic Index Model for Children and Adolescents with Hodgkin's Lymphoma Who Underwent Autologous Hematopoietic Stem Cell Transplantation: A Multicenter Study of the Turkish Pediatric Bone Marrow Transplantation Study Group.
OBJECTIVE
The prognostic factors and a new childhood prognostic index after autologous hematopoietic stem cell transplantation (AHSCT) in patients with relapsed/refractory Hodgkin's lymphoma (HL) were evaluated.


METHODS
The prognostic factors of 61 patients who underwent AHSCT between January 1990 and December 2014 were evaluated. In addition, the Age-Adjusted International Prognostic Index and the Childhood International Prognostic Index (CIPI) were evaluated for their impact on prognosis.


RESULTS
The median age of the 61 patients was 14.8 years (minimum-maximum: 5-20 years) at the time of AHSCT. There were single relapses in 28 patients, ≥2 relapses in eight patients, and refractory disease in 25 patients. The chemosensitivity/chemorefractory ratio was 36/25. No pretransplant radiotherapy, no remission at the time of transplantation, posttransplant white blood cell count over 10x103/µL, posttransplant positron emission tomography positivity at day 100, and serum albumin of <2.5 g/dL at diagnosis were correlated with progression-free survival. No remission at the time of transplantation, bone marrow positivity at diagnosis, and relapse after AHSCT were significant parameters for overall survival.


CONCLUSIONS
The major factors affecting the progression-free and overall survival were clearly demonstrated. A CIPI that uses a lactate dehydrogenase level of 500 IU/L worked well for estimating the prognosis. We recommend AHSCT at first complete remission for relapsed cases, and it should also be taken into consideration for patients with high prognostic scores at diagnosis.
Gülhane Training and Research Hospital Clinic of Pediatric Oncology, Ankara, Turkey Phone: +90 312 304 43 94 E-mail: vural73@yahoo.com.
Vural
V
Kesik
Erman
E
Ataş
Musa
M
Karakükcü
Serap
S
Aksoylar
Fatih
F
Erbey
Nurdan
N
Taçyıldız
Alphan
A
Küpesiz
Haldun
H
Öniz
Ekrem
E
Ünal
Savaş
S
Kansoy
Gülyüz
G
Öztürk
Murat
M
Elli
Zühre
Z
Kaya
Emel
E
Ünal
Volkan
V
Hazar
Şebnem
Ş
Yılmaz Bengoa
Gülsün
G
Karasu
Didem
D
Atay
Ayhan
A
Dağdemir
Hale
H
Ören
Ülker
Ü
Koçak
M Akif
MA
Yeşilipek
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult