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Bone Marrow Transplant ; 50(11): 1416-23, 2015 Nov.
Article de Anglais | MEDLINE | ID: mdl-26237164

RÉSUMÉ

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.


Sujet(s)
Transplantation de cellules souches hématopoïétiques , Maladie de Hodgkin/thérapie , Modèles théoriques , Adolescent , Adulte , Protocoles de polychimiothérapie antinéoplasique/usage thérapeutique , Cause de décès , Enfant , Enfant d'âge préscolaire , Association thérapeutique , Évolution de la maladie , Survie sans rechute , Femelle , Études de suivi , Maladie de Hodgkin/traitement médicamenteux , Maladie de Hodgkin/mortalité , Maladie de Hodgkin/radiothérapie , Humains , Mâle , Seconde tumeur primitive/épidémiologie , Pronostic , Modèles des risques proportionnels , Études rétrospectives , Thérapie de rattrapage , Transplantation autologue , Jeune adulte
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