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Haematopoietic SCT for children and adolescents with relapsed and refractory Hodgkin's lymphoma

Bone Marrow Transplantation volume 42, pages S16–S24 (2008)Cite this article

Abstract

Despite the generally excellent prognosis of children and adolescents with Hodgkin's lymphoma (HL), approximately 15% of patients relapse. Salvage therapy options include further chemo-radiotherapy and autologous or allogeneic haematopoietic SCT (HSCT). Autologous HSCT following high-dose chemotherapy, the standard treatment for adult patients with relapsed HL, is also effective in paediatric patients, but randomized trials showing its superiority to conventional therapy are lacking. Although patients with late relapse (>12 months after completion of therapy) may be cured with conventional therapy, those with progressive disease or early relapse (3–12 months) are considered candidates for autologous HSCT. According to patient selection criteria, overall and disease-free survival rates after autologous HSCT are 43–95% and 31–70%, respectively. Short time to relapse and refractory disease at the time of autologous HSCT remain the most important risk factors. Data on allogeneic HSCT in children with HL are scarce. Broader use has been hampered for a long time mainly by high non-relapse mortality, offsetting the advantage of a graft-vs-lymphoma effect. Data suggest that young patients with recurring disease following autologous HSCT, as well as some patients with multiple relapses and selected patients with refractory lymphoma, might benefit from allogeneic HSCT, but relapse remains the major challenge.

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Acknowledgements

We are grateful to all transplant centres for providing clinical data and to the Lymphoma and Paediatric Diseases Working Parties for their support. We thank Carme Canals for her excellent assistance.

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  1. Department of Paediatrics and BMT Unit, University Hospital of Schleswig-Holstein Campus Kiel, Kiel, Germany

    A Claviez

  2. Clinical Hematology Division, Hospital Santa Creu i Sant Pau, Barcelona, Spain

    A Sureda

  3. Department of Haematology and Stem Cell Transplantation, Asklepios Clinic St Georg, Hamburg, Germany

    N Schmitz

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Correspondence to A Claviez.

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Claviez, A., Sureda, A. & Schmitz, N. Haematopoietic SCT for children and adolescents with relapsed and refractory Hodgkin's lymphoma. Bone Marrow Transplant 42 (Suppl 2), S16–S24 (2008). https://doi.org/10.1038/bmt.2008.278

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