A prognostic model predicting autologous transplantation outcomes in children, adolescents and young adults with Hodgkin lymphoma

P. Satwani, K. W. Ahn, J. Carreras, H. Abdel-Azim, M. S. Cairo, A. Cashen, A. I. Chen, J. B. Cohen, L. J. Costa, C. Dandoy, T. S. Fenske, C. O. Freytes, S. Ganguly, R. P. Gale, N. Ghosh, M. S. Hertzberg, R. J. Hayashi, R. T. Kamble, A. S. Kanate, A. KeatingM. A. Kharfan-Dabaja, H. M. Lazarus, D. I. Marks, T. Nishihori, R. F. Olsson, T. D. Prestidge, J. M. Rolon, B. N. Savani, J. M. Vose, W. A. Wood, D. J. Inwards, V. Bachanova, S. M. Smith, D. G. Maloney, A. Sureda, M. Hamadani

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48 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1416-1423
Number of pages8
JournalBone marrow transplantation
Volume50
Issue number11
DOIs
StatePublished - Nov 1 2015

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© 2015 Macmillan Publishers Limited. All rights reserved.

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