Hematology Department, Institute of Hematology and Oncology, Hospital Clinic, Barcelona, Spain.
Ann Oncol. 2013 Sep;24(9):2430-4. doi: 10.1093/annonc/mdt206. Epub 2013 May 26.
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care for patients with relapsed Hodgkin's lymphoma (HL). However, there is currently little information on the predictors of outcome for patients whose disease recurs after ASCT.
Five hundred and eleven adult patients with relapsed HL after ASCT from EBMT-GITMO databases were reviewed.
Treatments administered following ASCT failure included conventional chemotherapy and/or radiotherapy in 294 (64%) patients, second ASCT in 35 (8%), and alloSCT in 133 (29%). After a median follow-up of 49 months, overall survival (OS) was 32% at 5 years. Independent risk factors for OS were early relapse (<6 months) after ASCT, stage IV, bulky disease, poor performance status (PS), and age ≥50 years at relapse. For patients with no risk factors OS at 5 years was 62% compared with 37% and 12% for those having 1 and ≥2 factors, respectively. This score was also predictive for outcome in each group of rescue treatment after ASCT failure.
CONCLUSION(S): Early relapse, stage IV, bulky disease, poor PS, and age ≥50 years at ASCT failure are relevant factors for outcome that may help to understand the results of different therapeutic approaches.
大剂量化疗后自体造血干细胞移植（ASCT）是复发性霍奇金淋巴瘤（HL）患者的标准治疗方法。然而，目前关于 ASCT 后疾病复发患者结局预测因素的信息较少。
从 EBMT-GITMO 数据库中回顾了 511 例 ASCT 后复发的成人 HL 患者。
ASCT 失败后给予的治疗包括 294 例（64%）患者的常规化疗和/或放疗、35 例（8%）患者的第二次 ASCT 和 133 例（29%）患者的 alloSCT。中位随访 49 个月后，5 年总生存率（OS）为 32%。OS 的独立危险因素是 ASCT 后早期复发（<6 个月）、IV 期、大肿块疾病、较差的体能状态（PS）和复发时年龄≥50 岁。对于无风险因素的患者，5 年 OS 为 62%，而有 1 个和≥2 个因素的患者分别为 37%和 12%。该评分也可预测 ASCT 失败后每种挽救治疗的结果。
ASCT 失败时的早期复发、IV 期、大肿块疾病、较差的 PS 和年龄≥50 岁是与结局相关的重要因素，可能有助于了解不同治疗方法的结果。
