A prognostic model predicting autologous transplantation outcomes in children, adolescents and young adults with Hodgkin lymphoma.
Bone Marrow Transplant
; 50(11): 1416-23, 2015 Nov.
Article
in En
| MEDLINE
| ID: mdl-26237164
ABSTRACT
Autologous hematopoietic cell transplantation (AutoHCT) is a potentially curative treatment modality for relapsed/refractory Hodgkin lymphoma (HL). However, no large studies have evaluated pretransplant factors predictive of outcomes of AutoHCT in children, adolescents and young adults (CAYA, age <30 years). In a retrospective study, we analyzed 606 CAYA patients (median age 23 years) with relapsed/refractory HL who underwent AutoHCT between 1995 and 2010. The probabilities of PFS at 1, 5 and 10 years were 66% (95% confidence interval (CI) 62-70), 52% (95% CI 48-57) and 47% (95% CI 42-51), respectively. Multivariate analysis for PFS demonstrated that at the time of AutoHCT patients with Karnofsky/Lansky score ⩾90, no extranodal involvement and chemosensitive disease had significantly improved PFS. Patients with time from diagnosis to first relapse of <1 year had a significantly inferior PFS. A prognostic model for PFS was developed that stratified patients into low-, intermediate- and high-risk groups, predicting for 5-year PFS probabilities of 72% (95% CI 64-80), 53% (95% CI 47-59) and 23% (95% CI 9-36), respectively. This large study identifies a group of CAYA patients with relapsed/refractory HL who are at high risk of progression after AutoHCT. Such patients should be targeted for novel therapeutic and/or maintenance approaches post-AutoHCT.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hodgkin Disease
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Hematopoietic Stem Cell Transplantation
/
Models, Theoretical
Type of study:
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
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Child
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Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Bone Marrow Transplant
Year:
2015
Document type:
Article