Outcome of autologous hematopoietic stem cell transplantation in children and adolescents with relapsed or refractory Hodgkin's lymphoma |
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| Authors: | Volkan Hazar Vural Kesik Serap Aksoylar Musa Karakukcu Gulyuz Ozturk Alphan Kupesiz Erman Atas Haldun Oniz Savas Kansoy Ekrem Unal Atila Tanyeli Fatih Erbey Murat Elli Nurdan Tacyildiz Gulsun Tezcan Karasu Ulker Kocak Sema Anak Sebnem Yilmaz Bengoa Gulay Sezgin Didem Atay Emel Unal Vedat Uygun Nilgun Kurucu Zuhre Kaya the Turkish Pediatric Bone Marrow Transplantation Study Group |
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| Affiliation: | 1. Pediatric BMT Units, Medipol University Faculty of Medicine, Istanbul, Turkey;2. Pediatric BMT Units, Gulhane Military Medical Academy, Ankara, Turkey;3. Pediatric BMT Units, Ege University Faculty of Medicine, Izmir, Turkey;4. Pediatric BMT Units, Erciyes University Faculty of Medicine, Kayseri, Turkey;5. Pediatric BMT Units, Medical Park Bahcelievler Hospital, ?stanbul, Turkey;6. Pediatric BMT Units, Akdeniz University Faculty of Medicine, Antalya, Turkey;7. Pediatric BMT Units, Tepecik Hospital, ?zmir, Turkey;8. Pediatric BMT Units, Cukurova University Faculty of Medicine, Adana, Turkey;9. Pediatric BMT Units, On Dokuz Mayis University Faculty of Medicine, Samsun, Turkey;10. Pediatric BMT Units, Ankara University Faculty of Medicine, Ankara, Turkey;11. Pediatric BMT Units, Bahcesehir University Faculty of Medicine Medical Park Goztepe Hospital, Istanbul, Turkey;12. Pediatric BMT Units, Gazi University Faculty of Medicine, Ankara, Turkey;13. Pediatric BMT Units, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey;14. Pediatric BMT Units, Bahcesehir University Faculty of Medicine, Medical Park Antalya Hospital, Antalya, Turkey;15. Pediatric BMT Units, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey;16. Pediatric BMT Units, Ankara Oncology Hospital, Ankara, Turkey |
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| Abstract: | This study evaluates the outcome of 66 pediatric patients with rrHL who underwent autoHSCT. Twenty‐nine patients experienced early relapse, and 19 patients experienced late relapse. Of 18 newly diagnosed with HL, 13 were primary refractory disease and five had late responsive disease. At the time of transplantation, only 68% of the patients were chemosensitive. The majority of patients received BCNU + etoposide + ara‐C + melphalan for conditioning (45/66), and peripheral blood (56/66) was used as a source of stem cells. After a median follow‐up period of 39 months, 46 patients were alive. At five yr, the probabilities of OS, EFS, the relapse rate, and the non‐relapse mortality rate were 63.1%, 54.3%, 36.4%, and 9.1%, respectively. The probability of EFS in chemosensitive and chemoresistant patients at five yr was 72.3% and 19%, respectively (p < 0.001). Multivariate analysis showed that chemoresistant disease at the time of transplantation was the only factor predicting limited both OS (hazard ratio = 4.073) and EFS (hazard ratio = 4.599). AutoHSCT plays an important role for the treatment of rrHL in children and adolescents, and survival rates are better for patients with chemosensitive disease at the time of transplantation. |
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| Keywords: | Hodgkin's lymphoma children and adolescents relapse refractory autologous hematopoietic stem cell transplantation survival |
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