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Disease Status at Transplant has a Significant Impact on Outcomes of Autologous Transplantation (ASCT) in Patients with Hodgkin Lymphoma—A Single Center Experience

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Abstract

High dose chemotherapy followed by autologous stem cell transplantation is the treatment of choice for relapsed Hodgkin lymphoma (HL). We analyzed 100 consecutive patients who underwent ASCT at our center between January 1999 and June 2019 for relapsed or refractory disease with a median age of 28 years (range: 9–65). At ASCT, 59 were in complete remission (CR) while 31 achieved partial remission (PR) and 10 had refractory disease (RD). Most had BEAM conditioning with a median infused cell dose of 4.84 × 106 CD 34 cells/kg. Prompt engraftment occurred in 97 patients at a median of 11 days. The day 100 transplant related mortality (TRM) was 5%. At a median of 37 months follow up, 79 patients are alive while 34 have relapsed. The 3-year event free survival (EFS) and overall survival (OS) are 62.3 ± 0.5% and 77.9 ± 4.4% respectively. The 3-year OS for patients in CR, PR and RD were 83.0 ± 5.2%, 78.4 ± 8.1% and 38.9 ± 1.7 respectively [p = 0.007] while the 3-year EFS for CR, PR and RD were 73.1 ± 6.2%, 61.3 ± 9.2% and 25.0 ± 1.5 respectively [p = 0.005]. Only disease status at time of ASCT was found to correlate with both OS and EFS. ASCT for HL is associated with good outcomes and low TRM. Disease status at ASCT impacted both OS and EFS and strategies to improve outcomes in patients with refractory disease needs to be explored.

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Funding

No funding used for this study—this is a retrospective analysis.

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Authors and Affiliations

  1. Department of Haematology, Christian Medical College, Vellore, Tamilnadu, India

    Jayastu Senapati, Anup J. Devasia, Anu Korula, N. A. Fouzia, Uday Kulkarni, Kavitha M. Lakshmi, Sharon Lionel, Aby Abraham, Alok Srivastava, Vikram Mathews & Biju George

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  1. Jayastu Senapati
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  2. Anup J. Devasia
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  3. Anu Korula
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  4. N. A. Fouzia
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  6. Kavitha M. Lakshmi
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  7. Sharon Lionel
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  11. Biju George
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Contributions

BG, JS—conceived the study, collected data, did the preliminary analysis and wrote the manuscript. AJD, AK, FNA, UK, KL, SL, AA, AS and VM—contributed data, performed critical analysis and reviewed the manuscript.

Corresponding author

Correspondence to Biju George.

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Retrospective study – IRB approval obtained for this retrospective analysis.

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Senapati, J., Devasia, A.J., Korula, A. et al. Disease Status at Transplant has a Significant Impact on Outcomes of Autologous Transplantation (ASCT) in Patients with Hodgkin Lymphoma—A Single Center Experience. Indian J Hematol Blood Transfus 38, 290–298 (2022). https://doi.org/10.1007/s12288-021-01450-9

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  • DOI: https://doi.org/10.1007/s12288-021-01450-9

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