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Annals of Oncology Advance Access published online on February 28, 2005
Annals of Oncology, doi:10.1093/annonc/mdi119
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© 2005 European Society for Medical Oncology
Received July 28, 2004
Revised October 8, 2004
Accepted November 23, 2004

Original article

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 , and for The Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GEL/TAMO) Cooperative Group

* To whom correspondence should be addressed.
A. Sureda, E-mail: asureda{at}hsp.santpau.es


  Abstract

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.

Keywords: autologous stem cell transplantation; first relapse; Hodgkin's lymphoma.
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