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. 2018 Feb 15;124(4):816-825.
doi: 10.1002/cncr.31114. Epub 2017 Nov 10.

Long-term outcomes among 2-year survivors of autologous hematopoietic cell transplantation for Hodgkin and diffuse large b-cell lymphoma

Regina M Myers  1 , Brian T Hill  2 , Bronwen E Shaw  3 , Soyoung Kim  3   4 , Heather R Millard  3 , Minoo Battiwalla  5 , Navneet S Majhail  6 , David Buchbinder  7 , Hillard M Lazarus  8 , Bipin N Savani  9 , Mary E D Flowers  10 , Anita D'Souza  3 , Matthew J Ehrhardt  11 , Amelia Langston  12 , Jean A Yared  13 , Robert J Hayashi  14 , Andrew Daly  15 , Richard F Olsson  16   17 , Yoshihiro Inamoto  18 , Adriana K Malone  19 , Zachariah DeFilipp  20 , Steven P Margossian  21 , Anne B Warwick  22 , Samantha Jaglowski  23 , Amer Beitinjaneh  24 , Henry Fung  25 , Kimberly A Kasow  26 , David I Marks  27 , Jana Reynolds  28 , Keith Stockerl-Goldstein  29 , Baldeep Wirk  30 , William A Wood  31 , Mehdi Hamadani  3 , Prakash Satwani  32
Affiliations

Long-term outcomes among 2-year survivors of autologous hematopoietic cell transplantation for Hodgkin and diffuse large b-cell lymphoma

Regina M Myers et al. Cancer. .

Abstract

Background: Autologous hematopoietic cell transplantation (auto-HCT) is a standard therapy for relapsed classic Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL); however, long-term outcomes are not well described.

Methods: This study analyzed survival, nonrelapse mortality, late effects, and subsequent malignant neoplasms (SMNs) in 1617 patients who survived progression-free for ≥2 years after auto-HCT for cHL or DLBCL between 1990 and 2008. The median age at auto-HCT was 40 years; the median follow-up was 10.6 years.

Results: The 5-year overall survival rate was 90% (95% confidence interval [CI], 87%-92%) for patients with cHL and 89% (95% CI, 87%-91%) for patients with DLBCL. The risk of late mortality in comparison with the general population was 9.6-fold higher for patients with cHL (standardized mortality ratio [SMR], 9.6) and 3.4-fold higher for patients with DLBCL (SMR, 3.4). Relapse accounted for 44% of late deaths. At least 1 late effect was reported for 9% of the patients. A total of 105 SMNs were confirmed: 44 in the cHL group and 61 in the DLBCL group. According to a multivariate analysis, older age, male sex, a Karnofsky score < 90, total body irradiation (TBI) exposure, and a higher number of lines of chemotherapy before auto-HCT were risk factors for overall mortality in cHL. Risk factors in DLBCL were older age and TBI exposure. A subanalysis of 798 adolescent and young adult patients mirrored the outcomes of the overall study population.

Conclusions: Despite generally favorable outcomes, 2-year survivors of auto-HCT for cHL or DLBCL have an excess late-mortality risk in comparison with the general population and experience an assortment of late complications. Cancer 2018;124:816-25. © 2017 American Cancer Society.

Keywords: Hodgkin lymphoma; autologous hematopoietic cell transplant; diffuse large B-cell lymphoma; late effects; nonrelapse mortality; survival.

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Conflict of interest statement

None of the authors have any relevant conflict of interest to disclose.

Figures

Figure 1
Figure 1
Survival outcomes among two-year survivors of autoHCT for cHL and DLBCL
See this image and copyright information in PMC

References

    1. Hamadani M, Hari PN, Zhang Y, et al. Early failure of frontline rituximab-containing chemo-immunotherapy in diffuse large B cell lymphoma does not predict futility of autologous hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2014;20:1729–36. - PMC - PubMed
    1. Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med. 1995;333:1540–5. - PubMed
    1. Hazar V, Kesik V, Aksoylar S, et al. Outcome of autologous hematopoietic stem cell transplantation in children and adolescents with relapsed or refractory Hodgkin’s lymphoma. Pediatr Transplant. 2015;19:745–52. - PubMed
    1. Garfin PM, Link MP, Donaldson SS, et al. Improved outcomes after autologous bone marrow transplantation for children with relapsed or refractory Hodgkin lymphoma: twenty years experience at a single institution. Biol Blood Marrow Transplant. 2015;21:326–34. - PubMed
    1. Lazarus HM, Loberiza FR, Jr, Zhang MJ, et al. Autotransplants for Hodgkin’s disease in first relapse or second remission: a report from the autologous blood and marrow transplant registry (ABMTR) Bone Marrow Transplant. 2001;27:387–96. - PubMed

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