A prognostic model predicting autologous transplantation outcomes in children, adolescents and young adults with Hodgkin lymphoma
2015 (English)In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 50, no 11, 1416-1423 p.Article in journal (Refereed) PublishedText
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.
Place, publisher, year, edition, pages
2015. Vol. 50, no 11, 1416-1423 p.
IdentifiersURN: urn:nbn:se:uu:diva-276892DOI: 10.1038/bmt.2015.177ISI: 000368281800004PubMedID: 26237164OAI: oai:DiVA.org:uu-276892DiVA: diva2:903679