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Autografting

Primary refractory Hodgkin's lymphoma: outcome after high-dose chemotherapy and autologous SCT and impact of various prognostic factors on overall and event-free survival. A single institution result of 66 patients

Bone Marrow Transplantation volume 40, pages 651–658 (2007)Cite this article

Abstract

We report our experience with high-dose chemotherapy (HDC) and autologous SCT (ASCT) in 66 patients with primary refractory Hodgkin's lymphoma (PR-HL) who received salvage chemotherapy followed by BEAM as HDC. Median age at ASCT was 23 years. Before salvage chemotherapy, stages I:II:III:IV were 2:21:14:29, bulky disease 27%, involvement of mediastinum 79%, spleen 26% and extranodal site 47%, 92% had ESHAP as salvage. Post-ASCT evaluation showed response in 50 patients (76%); complete response (CR) 37 (56%), partial response 14 (21%), no response or stable disease 3 (5%) and progressive disease in 10 (15%). Another five patients achieved CR after radiation therapy and one after surgery, making total CR 43 (65%). From diagnosis and HDC, median follow-up is 38.5 and 22.8 months and median overall survival (OS) 78 and 57 months, respectively. Event-free survival (EFS) and OS are 36 and 64%, respectively. In all, 47% patients are in CR. Twenty-two patients (33%) died due to disease. Multivariate analysis showed elevated lactate dehydrogenase (LDH) for EFS (P=0.041) and mediastinal involvement for OS (P=0.038) as negative prognostic factors. In conclusion, EFS and OS are only 36 and 64%, respectively. Elevated LDH and mediastinal involvement are poor prognostic factors.

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Acknowledgements

We thank Mr Ibrahim Abdullah Al-Hassan for statistical analysis, Ms Ruqaya Belkum, Mr Fayez Abu Zeid and Ms Fadia Mansour from BMT clinic, and Edgardo Colcol from the Oncology Data Unit for their valuable contribution.

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Authors and Affiliations

  1. Department of Oncology, King Faisal Cancer Center, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia

    S Akhtar, M Abdelsalam, H Hussaini, I Janabi & I Maghfoor

  2. Centre Hospitalier Public du Cotentin, Service d'Oncologie, Cherbourg-Octeville, France

    A El Weshi

  3. Department of Oncology, King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia

    M Rahal

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  1. S Akhtar
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Correspondence to S Akhtar.

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Akhtar, S., El Weshi, A., Abdelsalam, M. et al. Primary refractory Hodgkin's lymphoma: outcome after high-dose chemotherapy and autologous SCT and impact of various prognostic factors on overall and event-free survival. A single institution result of 66 patients. Bone Marrow Transplant 40, 651–658 (2007). https://doi.org/10.1038/sj.bmt.1705792

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