Abstract
Today the role of single or double Autologous Stem Cell Transplantation (ASCT) in patients (pts) with refractory Hodgkin Lymphoma (HL) is still unclear. Aim. To present the results of a single-center prospective trial which aim was to show the significance of single and double ASCT in patients with HL, who did not achieve complete response after first-line chemotherapy. Material and Methods. Between 2007 and 2014 62 patients were enrolled in the study. First ASCT was administered to 53 patients, 10 of those 53 patients received second ASCT. Results. 5-year overall survival (OS) and progression-free survival (PS) were 52 and 27% after single ASCT versus 38 and 30% after double ASCT respectively. According to our study extensive previous treatment (radiotherapy and chemotherapy) followed by ASCT had a negative prognostic impact on overall survival (OS) (p=0.03). Moreover, initial response to the first ASCT was found to be an independent prognostic factor of OS (p=0.004). According to our results, achievement ofpartial response or disease stabilization after the first ASCT was the main indication for double ASCT. In this case second ASCT is preferable to alternative treatment (p=0.004). Disease progression (PD) after the first ASCT seems to be a contraindication to the necessity of the second course of ASCT as low effectiveness and high level of toxicity do not improve treatment results in comparison to alternative treatment (p=0.6). Achievement of complete remission associated with disease free long-term survival and high quality of life. Achievement of complete remission was crucial at any treatment stage. Conclusion. ASCT is an effective treatment option for patients who never achieved CR. Second ASCT is a treatment of choice for patients with PR/SD after 1st ASCT. Nevertheless second ASCT does not improve outcome for patients with PD after 1st ASCT. Alternative variants of treatment are needed for this patient group.
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