title: High-dose chemotherapy and peripheral hematopoietic stem cell transplantation in relapsed/refractory Hodgkin's lymphoma.
abstract: OBJECTIVE
  High-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) is used to treat patients with relapsed Hodgkin's lymphoma. In this retrospective study we report our experience with patients who underwent HDCT and ASCT.
  
  
  METHODS
  All patients ≥15 years old with relapsed/refractory Hodgkin's lymphoma who underwent HDCT and ASCT between June 2001 and December 2013 were included.
  
  
  RESULTS
  Fifty-four patients were identified. Median age at transplant was 22 years (range 15-49 years); 26 were men and 28 were women. Forty-eight patients (89%) underwent HDCT and ASCT after achieving a radiological response to salvage chemotherapy. The rate of radiological complete response to salvage chemotherapy was 13% and reached 50% within 3 months of ASCT in assessable patients. After a median follow-up of 25 months, 31 patients (57%) were still alive with no evidence of relapse or progression. Median event-free survival (EFS) was 24 months (95% CI 8.7-39.3) and 3-year EFS was 56%. Median overall survival (OS) was not reached and 3-year OS was 82.5%. Bulky mediastinal disease at relapse, hemoglobin level, and number of salvage regimens did not significantly impact EFS in univariate and multivariate analyses. After transplantation there was a trend towards longer EFS (30 vs. 24 months; p = 0.36) in patients with a longer time from the end of first-line treatment until relapse (≥12 vs. <12 months). The 100-day transplant-related mortality was 5.5%.
  
  
  CONCLUSIONS
  HDCT and ASCT for relapsed/refractory Hodgkin's lymphoma is safe. Our findings are consistent with published phase III results. Longer follow-up is warranted.
authors.affiliation: 1 Department of Oncology, King Faisal Specialist Hospital & Research Center, Jeddah - Saudi Arabia.
authors.forename: Mouhammed
authors.initials: M
authors.lastname: Kelta
authors.affiliation: 1 Department of Oncology, King Faisal Specialist Hospital & Research Center, Jeddah - Saudi Arabia.|2 College of Medicine, Al-Faisal University, Riyadh - Saudi Arabia.
authors.forename: Jamal
authors.initials: J
authors.lastname: Zekri
authors.affiliation: 1 Department of Oncology, King Faisal Specialist Hospital & Research Center, Jeddah - Saudi Arabia.|3 National Cancer Institute, Cairo University, Cairo - Egypt.
authors.forename: Ehab
authors.initials: E
authors.lastname: Abdelghany
authors.affiliation: 1 Department of Oncology, King Faisal Specialist Hospital & Research Center, Jeddah - Saudi Arabia.
authors.forename: Jalil Ur
authors.initials: JU
authors.lastname: Rehman
authors.affiliation: 1 Department of Oncology, King Faisal Specialist Hospital & Research Center, Jeddah - Saudi Arabia.
authors.forename: Zahid Amin
authors.initials: ZA
authors.lastname: Khan
authors.affiliation: 1 Department of Oncology, King Faisal Specialist Hospital & Research Center, Jeddah - Saudi Arabia.
authors.forename: Rawan
authors.initials: R
authors.lastname: Al-Saadi
authors.affiliation: 1 Department of Oncology, King Faisal Specialist Hospital & Research Center, Jeddah - Saudi Arabia.|2 College of Medicine, Al-Faisal University, Riyadh - Saudi Arabia.
authors.forename: Reyad
authors.initials: R
authors.lastname: Dada
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D014182:Transplantation, Autologous / Q000379:methods; D055815:Young Adult
keywords: Autologous stem cell transplantation; High-dose chemotherapy; Hodgkin’s lymphoma