Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Division of Hematology and Oncology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Leuk Lymphoma. 2021 Oct;62(10):2408-2415. doi: 10.1080/10428194.2021.1927016. Epub 2021 May 14.
For relapsed Hodgkin lymphoma, salvage chemotherapy followed by auto-HCT is the standard of care. It is important to identify subpopulations who could benefit from allo-HCT. This retrospective analysis included 277 patients with rrHL who underwent first transplant with auto-HCT or allo-HCT between 2007-2017. Patients in the auto-HCT cohort ( = 218) were older, more likely to be in CR at the time of transplant and receive maintenance therapy post-transplant. Patients who underwent allo-HCT ( = 59) had a higher MSKCC relapse score. Factors associated with an inferior PFS and OS included early relapse, advanced stage, extranodal involvement and not achieving CR following salvage chemotherapy. After controlling for these 4 risk factors and MSKCC score, PFS ( = 0.112) or OS ( = 0.256) was not affected by the choice of transplant. In patients with ≥ 3 high risk features, the 4-year PFS was 51% in the allo-HCT vs. 39% ( = 0.107) in the auto-HCT cohort.
对于复发性霍奇金淋巴瘤，挽救性化疗后自体造血干细胞移植（auto-HCT）是标准治疗方法。识别可能从异基因造血干细胞移植（allo-HCT）中获益的亚群非常重要。本回顾性分析纳入了 2007 年至 2017 年间接受首次自体-HCT 或 allo-HCT 移植的 277 例 rrHL 患者。auto-HCT 队列（n=218）的患者年龄较大，移植时更有可能处于完全缓解（CR）状态，并在移植后接受维持治疗。allo-HCT 组（n=59）的 MSKCC 复发评分更高。与较差的无进展生存（PFS）和总生存（OS）相关的因素包括早期复发、晚期疾病、结外受累以及挽救性化疗后未达到 CR。在控制了这 4 个危险因素和 MSKCC 评分后，移植选择对 PFS（P=0.112）或 OS（P=0.256）没有影响。在≥3 个高危特征的患者中，allo-HCT 组的 4 年 PFS 为 51%，而 auto-HCT 组为 39%（P=0.107）。
