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Outcome after autologous stem cell transplantation in primary refractory or relapsed Hodgkin lymphoma-a long-term follow-up single center experience.
Annals of Hematology ( IF 3.5 ) Pub Date : 2020-01-02 , DOI: 10.1007/s00277-019-03900-x
Malte Roerden 1 , Martin Sökler 1 , Lothar Kanz 1 , Wolfgang Bethge 1 , Wichard Vogel 1 , Juliane S Walz 1
Affiliation  

Autologous stem cell transplantation (autoSCT) can achieve long-term remission in primary refractory or relapsed Hodgkin lymphoma (r/r HL); however, still up to 50% of patients relapse after autoSCT. In this retrospective analysis, we investigated the impact of autologous stem cell transplantation in a consecutive, unselected cohort of primary refractory and relapsed Hodgkin lymphoma patients (n = 66) with the majority of patients treated in the pre-brentuximab vedotin and immune checkpoint inhibitor era. In our cohort, a 5-year overall survival (OS) from autoSCT of 59.5% and a 5-year progression-free survival (PFS) after autoSCT of 46.1% was achieved. Multivariate analysis revealed primary refractory disease and early relapse (< 12 months) after initial therapy as well as the presence of B symptoms at relapse as independent risk factors associated with a higher risk for relapse and an inferior PFS and OS. Several other clinical factors, including the presence of extranodal disease at relapse and failure to achieve a complete response to salvage chemotherapy, were associated with a trend towards an inferior survival. Patients relapsing after autoSCT had a particularly poor outcome, regardless of eligibility to undergo allogeneic stem cell transplantation (alloSCT). We further evaluated recently published prognostic models for r/r HL patients undergoing autoSCT and could validate several risk scores in our independent "real world" cohort.

中文翻译:

自体干细胞移植在原发性难治性或复发性霍奇金淋巴瘤中的结果-长期随访的单中心经验。

自体干细胞移植(autoSCT)可在原发性难治性或复发性霍奇金淋巴瘤(r / r HL)中获得长期缓解;但是,仍有高达50%的患者在autoSCT后复发。在这项回顾性分析中,我们调查了自体干细胞移植对连续的,未选择的原发性难治性和复发性霍奇金淋巴瘤患者(n = 66)的影响,其中大多数患者接受了brentuximab vedotin和免疫检查点抑制剂时代的治疗。在我们的队列中,autoSCT的5年总生存(OS)为59.5%,autoSCT后的5年无进展生存(PFS)为46.1%。多因素分析显示原发性难治性疾病和早期复发(< 初始治疗后12个月)以及复发时出现B症状是与复发风险较高以及PFS和OS较低相关的独立危险因素。其他一些临床因素,包括复发时存在结外性疾病以及对挽救性化学疗法无法完全反应的情况,均与生存期较差的趋势有关。autoSCT后复发的患者,无论是否接受异体干细胞移植(alloSCT),都具有特别差的结果。我们进一步评估了最近发表的针对进行autoSCT的r / r HL患者的预后模型,并可以验证我们独立的“现实世界”队列中的几个风险评分。包括复发时存在淋巴结外疾病以及对挽救性化学疗法无法完全反应,均与生存期降低趋势相关。autoSCT后复发的患者,无论是否接受异体干细胞移植(alloSCT),都具有特别差的结果。我们进一步评估了最近发表的针对进行autoSCT的r / r HL患者的预后模型,并可以验证我们独立的“现实世界”队列中的几个风险评分。包括复发时存在淋巴结外疾病以及对挽救性化学疗法无法完全反应,均与生存期降低趋势相关。autoSCT后复发的患者,无论是否接受异体干细胞移植(alloSCT),都具有特别差的结果。我们进一步评估了最近发表的针对进行autoSCT的r / r HL患者的预后模型,并可以验证我们独立的“现实世界”队列中的几个风险评分。
更新日期:2020-01-04
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