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SALVAGE CHEMOTHERAPY FOLLOWED BY AUTOLOGOUS STEM CELL TRANSPLANTATION MAY BE CURATIVE IN 50% OF RELAPSED OR REFRACTORY CLASSICAL HODGKIN LYMPHOMA: A SINGLE-CENTER EXPERIENCE
VIBOR MILUNOVIĆ
orcid.org/0000-0003-0069-6688
; Klinička bolnica Merkur, Klinika za unutarnje bolesti, Zavod za hematologiju, Zagreb, Hrvatska i Lombardi Comprehensive Cancer Centre, Georgetown University, Washington D.C., Sjedinjene Američke Države
MARTINA BOGELJIĆ PATEKAR
; Klinička bolnica Merkur, Klinika za unutarnje bolesti, Zavod za hematologiju, Zagreb, Hrvatska
NIKOLA ZAGORAC
; Sveučilište u Zagrebu, Medicinski fakultet, Zagreb, Hrvatska
DRAŽEN PERICA
; Sveučilište u Zagrebu, Medicinski fakultet, Zagreb, Hrvatska
INGA MANDAC ROGULJ
; Klinička bolnica Merkur, Klinika za unutarnje bolesti, Zavod za hematologiju, Zagreb, Hrvatska
IKA KARDUM-SKELIN
; Klinička bolnica Merkur, Zavod za citologiju i citogenetiku, Zagreb, Hrvatska
ANA PLANINC-PERAICA
; Sveučilište u Zagrebu, Medicinski fakultet i Klinička bolnica Merkur, Klinika za unutarnje bolesti, Zavod za hematologiju, Zagreb, Hrvatska
SLOBODANKA OSTOJIĆ KOLONIĆ
; Sveučilište u Zagrebu, Medicinski fakultet i Klinička bolnica Merkur, Klinika za unutarnje bolesti, Zavod za hematologiju, Zagreb, Hrvatska
Sažetak
The main aim of this study was to present outcomes and prognostic factors in relapsed and refractory classical Hodgkin lymphoma undergoing salvage chemotherapy followed by stem cell transplantation. This retrospective study included 101 adult patients being treated at a single center in the period between 1995-2014. The most commonly used salvage chemotherapy was miniBEAM. All patients received BEAM myeloablative protocol followed by stem cell reinfusion. The ORR was 92.1%. After a median of follow-up of 42 months, 5-year OS rate was 56% with 5-year PFS rate being 51%. In each survival curve, a plateau was achieved implying the curative possibility of autologous stem cell transplantation. Adverse prognostic factors associated with worse OS were presence of B symptoms and anemia at relapse and chemoresistance to salvage chemotherapy, defi ned as inability to achieve 2nd complete remission. However, in survival curve a plateau was reached indicating that 40% of chemorefractory patients can be cured with this approach. Only prognostic factor associated with inferior PFS was chemoresistance to salvage therapy. Outcomes for patients not responding to or relapsing after stem cell transplantation were less advantageous with 31% and 16% 5-years OS rates, stressing the need for better clinical approach in this subpopulation. Based on our results and according to the literature review, we demonstrate that salvage therapy followed by autologous stem cell transplantation represents a treatment of choice in transplant-eligible patients suffering from relapsed or refractory Hodgkin lymphoma.
Ključne riječi
classical Hodgkin lymphoma; salvage chemotherapy; stem cell transplantation; overall survival; prognosis
Hrčak ID:
184904
URI
Datum izdavanja:
19.7.2017.
Posjeta: 2.506 *