ISHL10 Abstract P107

The role of stem cell transplantation (SCT) in Hodgkin’s disease; perspectives from retrospective analysis

PURPOSE. To disclose the prognostic value of status of disease and lines of therapy at transplantation (SCT) either autologous or allogeneic in Hodgkin lymphoma we did a retrospective evaluation. PATIENTS AND METHODS. We accrued all patients who did a stem cell transplant (SCT) procedure following resistance, residual disease, or relapse after previous conventional therapy. The accrual started in October 1998 when we did the first autologous SCT with the use of peripheral stem cells (PSC) and included patients up to December 2015. One hundred eighty one patients with Hodgkin lymphoma did autologous and 40 patients did allogeneic SCT and analyzed for prognosis according to status and number of lines of therapy at transplant. Five categories of patients were identified according the status at transplant: primary resistant, with residual disease, in first relapse, in second relapse and more than second relapse. Autologous SCT was done as II, III, IV line and more than IV line of therapy. High dose therapy followed by autologous PSCT represented a line of therapy for almost all patients who did allogeneic SCT. The analysis included the evaluation of survival according to groups identified and see if there are significant differences. RESULTS. Worse chances of survival were for patients primary resistant, 6% at 138 months, and for those with more than two relapses,10% at 120 months; better chance were for patients with residual disease, 88% and those who did transplantation following I relapse, 96% at 194 months (p<0.0001) (figure). In addition better survival was for patients who received autologous SCT as II line of therapy, 93% survival at 194 months, and worse those with more than IV line of therapy, 12% at 146 months (p<0.0001). Allogeneic SCT was done in 38 (95%) patients following autologous SCT; survival was 16% at 175 months and relapse-free survival (RFS) was 18% at 174 months. The stratification of survival in the setting of allogeneic SCT was worse for patients resistant and with previous more lines of therapy. CONCLUSIONS. Our study demonstrates that Hodgkin lymphoma may be cured by high-dose therapy and a procedure of SCT following failure to conventional therapies. However, different outcomes were recorded according the status of disease and the line of therapy at transplant; differentiated therapeutic approaches to various patients categories will be discussed.

Authors

  • P. Mazza
  • N. Cascavilla
  • P. Galieni
  • G. Palazzo
  • A.M. Carella
  • S. Falcioni
  • G. Pisapia
  • E. Merla
  • B. Amurri
  • S. Angelini