Different response to salvage chemotherapy but similar post-transplant outcomes in patients with relapsed and refractory Hodgkin's lymphoma

Noemi Puig, Melania Pintilie, Tara Seshadri, Khalil Al-Farsi, Tracy Nagy, Norman Franke, Richard Tsang, Armand Keating, Michael Crump, John Kuruvilla

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background The use of high-dose chemotherapy and autologous stem-cell transplantation in patients with relapsed Hodgkin's lymphoma is supported by two randomized clinical trials but its benefit in patients with primary refractory disease is less clear. Aiming to shed light on this issue, we analyzed and compared the outcomes of patients with relapsed or refractory Hodgkin's lymphoma treated with second-line chemotherapy and planned autologous stem-cell transplantation. Design and Methods We retrospectively analyzed data on 157 consecutive patients with Hodgkin's lymphoma referred to our institution for consideration of autologous stem-cell transplantation between 1999 and 2006. Of those, 73 met the definition of having primary refractory disease, ie. progressive disease during first line chemotherapy or within 3 months of completion of the treatment. Those patients achieving complete remission, partial remission and stable disease with symptomatic improvement after two or three cycles of salvage chemotherapy proceeded to stem cell mobilization and autologous transplantation. Results From first relapse/progression, the 3-year overall survival was 76% (95% CI: 66%-89%) for the refractory cohort and 91% (95% CI: 84%-98%) for the relapsed cohort (P=0.034); the overall response rate to second-line chemotherapy was 51% and 83% (P<0.0001), respectively. Threeyear progression-free survival post-transplant was 49% in refractory patients and 67% in relapsed patients (P=0.21); overall survival was 75% and 91% (P=0.097), respectively. Conclusions Using the group with relapsed disease as a reference, we can conclude that the subset of patients with chemosensitive primary refractory Hodgkin's lymphoma do benefit from autologous stem-cell transplantation.

Original languageEnglish
Pages (from-to)1496-1502
Number of pages7
JournalHaematologica
Volume95
Issue number9
DOIs
Publication statusPublished - Sep 2010

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Hodgkin Disease
Stem Cell Transplantation
Transplants
Drug Therapy
Hematopoietic Stem Cell Mobilization
Survival
Autologous Transplantation
Disease-Free Survival
Randomized Controlled Trials
Recurrence

Keywords

  • Hodgkin's lymphoma
  • Refractory
  • Transplantation

ASJC Scopus subject areas

  • Hematology

Cite this

Different response to salvage chemotherapy but similar post-transplant outcomes in patients with relapsed and refractory Hodgkin's lymphoma. / Puig, Noemi; Pintilie, Melania; Seshadri, Tara; Al-Farsi, Khalil; Nagy, Tracy; Franke, Norman; Tsang, Richard; Keating, Armand; Crump, Michael; Kuruvilla, John.

In: Haematologica, Vol. 95, No. 9, 09.2010, p. 1496-1502.

Research output: Contribution to journalArticle

Puig, N, Pintilie, M, Seshadri, T, Al-Farsi, K, Nagy, T, Franke, N, Tsang, R, Keating, A, Crump, M & Kuruvilla, J 2010, 'Different response to salvage chemotherapy but similar post-transplant outcomes in patients with relapsed and refractory Hodgkin's lymphoma', Haematologica, vol. 95, no. 9, pp. 1496-1502. https://doi.org/10.3324/haematol.2009.019943
Puig, Noemi ; Pintilie, Melania ; Seshadri, Tara ; Al-Farsi, Khalil ; Nagy, Tracy ; Franke, Norman ; Tsang, Richard ; Keating, Armand ; Crump, Michael ; Kuruvilla, John. / Different response to salvage chemotherapy but similar post-transplant outcomes in patients with relapsed and refractory Hodgkin's lymphoma. In: Haematologica. 2010 ; Vol. 95, No. 9. pp. 1496-1502.
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AU - Puig, Noemi

AU - Pintilie, Melania

AU - Seshadri, Tara

AU - Al-Farsi, Khalil

AU - Nagy, Tracy

AU - Franke, Norman

AU - Tsang, Richard

AU - Keating, Armand

AU - Crump, Michael

AU - Kuruvilla, John

PY - 2010/9

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N2 - Background The use of high-dose chemotherapy and autologous stem-cell transplantation in patients with relapsed Hodgkin's lymphoma is supported by two randomized clinical trials but its benefit in patients with primary refractory disease is less clear. Aiming to shed light on this issue, we analyzed and compared the outcomes of patients with relapsed or refractory Hodgkin's lymphoma treated with second-line chemotherapy and planned autologous stem-cell transplantation. Design and Methods We retrospectively analyzed data on 157 consecutive patients with Hodgkin's lymphoma referred to our institution for consideration of autologous stem-cell transplantation between 1999 and 2006. Of those, 73 met the definition of having primary refractory disease, ie. progressive disease during first line chemotherapy or within 3 months of completion of the treatment. Those patients achieving complete remission, partial remission and stable disease with symptomatic improvement after two or three cycles of salvage chemotherapy proceeded to stem cell mobilization and autologous transplantation. Results From first relapse/progression, the 3-year overall survival was 76% (95% CI: 66%-89%) for the refractory cohort and 91% (95% CI: 84%-98%) for the relapsed cohort (P=0.034); the overall response rate to second-line chemotherapy was 51% and 83% (P<0.0001), respectively. Threeyear progression-free survival post-transplant was 49% in refractory patients and 67% in relapsed patients (P=0.21); overall survival was 75% and 91% (P=0.097), respectively. Conclusions Using the group with relapsed disease as a reference, we can conclude that the subset of patients with chemosensitive primary refractory Hodgkin's lymphoma do benefit from autologous stem-cell transplantation.

AB - Background The use of high-dose chemotherapy and autologous stem-cell transplantation in patients with relapsed Hodgkin's lymphoma is supported by two randomized clinical trials but its benefit in patients with primary refractory disease is less clear. Aiming to shed light on this issue, we analyzed and compared the outcomes of patients with relapsed or refractory Hodgkin's lymphoma treated with second-line chemotherapy and planned autologous stem-cell transplantation. Design and Methods We retrospectively analyzed data on 157 consecutive patients with Hodgkin's lymphoma referred to our institution for consideration of autologous stem-cell transplantation between 1999 and 2006. Of those, 73 met the definition of having primary refractory disease, ie. progressive disease during first line chemotherapy or within 3 months of completion of the treatment. Those patients achieving complete remission, partial remission and stable disease with symptomatic improvement after two or three cycles of salvage chemotherapy proceeded to stem cell mobilization and autologous transplantation. Results From first relapse/progression, the 3-year overall survival was 76% (95% CI: 66%-89%) for the refractory cohort and 91% (95% CI: 84%-98%) for the relapsed cohort (P=0.034); the overall response rate to second-line chemotherapy was 51% and 83% (P<0.0001), respectively. Threeyear progression-free survival post-transplant was 49% in refractory patients and 67% in relapsed patients (P=0.21); overall survival was 75% and 91% (P=0.097), respectively. Conclusions Using the group with relapsed disease as a reference, we can conclude that the subset of patients with chemosensitive primary refractory Hodgkin's lymphoma do benefit from autologous stem-cell transplantation.

KW - Hodgkin's lymphoma

KW - Refractory

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