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Annals of Oncology Advance Access originally published online on February 28, 2005
Annals of Oncology 2005 16(4):625-633; doi:10.1093/annonc/mdi119
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© 2005 European Society for Medical Oncology

Original articles

Prognostic factors affecting long-term outcome after stem cell transplantation in Hodgkin's lymphoma autografted after a first relapse

A. Sureda*, M. Constans, A. Iriondo, R. Arranz, M. D. Caballero, M. J. Vidal, J. Petit, A. López, J. J. Lahuerta, E. Carreras, J. García-Conde, J. García-Laraña, R. Cabrera, I. Jarque, D. Carrera, J. C. García-Ruiz, M. J. Pascual, J. Rifón, J. M. Moraleda, K. Pérez-Equiza, C. Albó, J. Díaz-Mediavilla, A. Torres, P. Torres, J. Besalduch, J. Marín, M. V. Mateos, J. M. Fernández-Rañada, J. Sierra, E. Conde for The Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GEL/TAMO) Cooperative Group

* Correspondence to: Dr A. Sureda, Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Antoni Maria i Claret, 167, 08025 Barcelona, Spain. Tel: +34-93-2919396; Fax: +34-93-2919466; Email: asureda{at}hsp.santpau.es

Purpose: To analyse outcome and prognostic factors for overall survival (OS) and time to treatment failure (TTF) in 357 patients with Hodgkin's lymphoma (HL) undergoing an autologous stem cell transplantation (ASCT) after a first relapse and reported to the The Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GEL/TAMO) Cooperative Group.

Methods: Two hundred and twenty males and 137 females with a median age of 29 years were autografted in second remission (n=181), first sensitive relapse (n=148) and first resistant relapse (n=28).

Results: Five-year actuarial TTF and OS were of 49% ± 3% and 57% ± 3%. Advanced stage at diagnosis, complementary radiotherapy before ASCT, a short first complete response (CR) and detectable disease at ASCT adversely influenced TTF. Year of transplant ≤1995, bulky disease at diagnosis, a short first CR, detectable disease at ASCT and ≥1 extranodal areas involved at ASCT were adverse factors for OS.

Conclusions: ASCT constitutes a therapeutic option for HL patients after a first relapse. Promising results are observed in patients with low tumour burden at diagnosis, autografted after a long CR and without detectable disease at ASCT. Innovative approaches should be pursued for patients with risk factors at relapse.

Key words: autologous stem cell transplantation, first relapse, Hodgkin's lymphoma


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