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. 2015 Nov;50(11):1416-23.
doi: 10.1038/bmt.2015.177. Epub 2015 Aug 3.

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

P Satwani  1 , K W Ahn  2   3 , J Carreras  2 , H Abdel-Azim  4 , M S Cairo  5 , A Cashen  6 , A I Chen  7 , J B Cohen  8 , L J Costa  9 , C Dandoy  10 , T S Fenske  11 , C O Freytes  12 , S Ganguly  13 , R P Gale  14 , N Ghosh  15 , M S Hertzberg  16 , R J Hayashi  17 , R T Kamble  18 , A S Kanate  19 , A Keating  20 , M A Kharfan-Dabaja  21 , H M Lazarus  22 , D I Marks  23 , T Nishihori  21 , R F Olsson  24   25 , T D Prestidge  26 , J M Rolon  27 , B N Savani  28 , J M Vose  29 , W A Wood  30 , D J Inwards  31 , V Bachanova  32 , S M Smith  33 , D G Maloney  34 , A Sureda  35 , M Hamadani  2
Affiliations

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

P Satwani et al. Bone Marrow Transplant. 2015 Nov.

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.

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Conflict of interest statement

Conflict-of-interest disclosure: No conflict of interests.

Figures

Figure 1
Figure 1
Autologous hematopoietic cell transplantation outcomes for children, adolescents and young adults with Hodgkin lymphoma 1A: Non-relapse related mortality. 1B: Progression/relapse. 1C: Progressions free survival. 1D: Overall survival.
Figure 2
Figure 2
Prognostic model predicting progression free survival for children, adolescents and young adults with Hodgkin lymphoma with low, intermediate and high risk scores [low vs. intermediate score (p=0.0002), low vs. high score (p<0.0001) and intermediate vs. high score (p<0.0001)].
See this image and copyright information in PMC

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