کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2105975 1546387 2006 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Long-Term Results of Autologous Stem Cell Transplantation for Primary Refractory or Relapsed Hodgkin’s Lymphoma
موضوعات مرتبط
علوم زیستی و بیوفناوری بیوشیمی، ژنتیک و زیست شناسی مولکولی تحقیقات سرطان
پیش نمایش صفحه اول مقاله
Long-Term Results of Autologous Stem Cell Transplantation for Primary Refractory or Relapsed Hodgkin’s Lymphoma
چکیده انگلیسی

Autologous hematopoietic stem cell transplantation (ASCT) has become standard therapy for primary refractory (PR REF) or relapsed (REL) Hodgkin’s lymphoma (HL); however, more than half of these patients eventually relapse and die of their disease. We studied long-term outcomes and evaluated factors influencing progression-free survival (PFS) in 141 patients with PR REF or REL HL who underwent ASCT between 1985 and 2003. Median age at ASCT was 30 years (range, 7–60 years); 21 patients had PR REF, and 120 had REL HL. With a median follow-up of 6.3 years (range, 1–20 years), the probability of PFS at 5 and 10 years was 48% (95% confidence interval [CI], 39%–57%) and 45% (95% CI, 36%–54%) and that of overall survival (OS) was 53% (95% CI, 44%–62%) and 47% (95% CI, 37%–57%), respectively. Transplant-related mortality at 100 days was 1.4%. Among 45 5- to 20-year survivors, no late relapses of HL were observed. In multivariate analysis, 3 factors were independently predictive of poor PFS: chemoresistant disease (relative risk [RR], 2.9; 95% CI, 1.7–5.0), B-symptoms at pretransplantation relapse (RR, 2.1; 95% CI, 1.3–3.4), and presence of residual disease at the time of transplantation (RR, 2.3; 95% CI, 1.1–4.8). Patients with 0 or 1 of these 3 adverse factors (low-risk disease) had a 5–year PFS of 67% (95% CI, 55%–79%) compared with 37% (95% CI, 22%–52%) in those with 2 factors (intermediate-risk group) and 9% (95% CI, 0–20%) in those with all 3 factors (high-risk group) (P < .001). The rates of OS at 5 years were 71% (95% CI, 60%–82%), 49% (95% CI, 33%–65%) and 13% (95% CI, 0–27%) in the 3 groups, respectively (P < .001). ASCT is associated with durable PFS in appropriately selected patients with PR REF or REL HL. Using a simple prognostic model, we can identify patients with high-risk disease who have predictably unfavorable outcome after ASCT and require novel therapeutic approaches. A risk-adapted approach should be followed in determining treatment options for patients with PR REF and REL HL.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: - Volume 12, Issue 10, October 2006, Pages 1065–1072
نویسندگان
, , , , , , , , , , ,