BACKGROUND:
Hodgkin's lymphoma has high rates of
cure, but in 15 percent to 20 percent of general
patients and between 35 percent and 40 percent of those in advanced stages, the
disease will progress or
will relapse after initial
treatment. For this group,
hematopoietic stem cell transplantation is considered one option of
salvage therapy.
OBJECTIVES:
To evaluate a group of 106
patients with
Hodgkin's lymphoma,
who suffered
relapse or
who were refractory to
treatment, submitted to autologous
hematopoietic stem cell transplantation in a single
transplant center.
METHODS:
A
retrospective study was performed with data collected from
patient charts. The
analysis involved 106 classical
Hodgkin's lymphoma patients who were consecutively submitted to high-
dose chemotherapy followed by
autologous transplants in a single institution from April 1993 to December 2006.
RESULTS:
The overall
survival rates of this
population at five and ten years were 86 percent and 70 percent, respectively. The
disease-free survival was approximately 60 percent at five years. Four
patients died of
procedure-related causes but
relapse of classical
Hodgkin's lymphoma after
transplant was the most frequent
cause of death. Univariate
analysis shows that
sensitivity to pre-
transplant treatment and
hemoglobin < 10 g/dL at
diagnosis had an impact on
patient survival. Unlike other studies, B-type symptoms did not seem to
affect overall
survival. Lactic
dehydrogenase and
serum albumin concentrations analyzed at
diagnosis did not influence
patient survival either.
CONCLUSION:
Autologous
hematopoietic stem cell transplantation is an effective
treatment strategy for early and late
relapse in classical
Hodgkin's lymphoma for cases that were responsive to pre-
transplant chemotherapy. Refractory to
treatment is a sign of worse
prognosis. Additionally, a
hemoglobin concentration below 10 g/dL at
diagnosis of
Hodgkin's lymphoma has a negative impact on the
survival of
patients after
transplant. As far as we know this relationship has not been previously reported.