The outcome of relapsed/refractory hodgkin's lymphoma patients post autologous bone marrow transplantation in a Baghdad Medical City Complex Center

Abstract

BACKGROUND: Early autologous hemopoietic stem cell transplant is the best option for treatment of relapsed or refractory Hodgkin lymphoma (HL), which is the standard of care at the time being. The aim of this study was to evaluate the outcome of patients with relapsed/refractory (R/R) HL who received autologous hemopoietic stem cell transplant.METHODS: This is a cohort study with data obtained from the patient's sheets and then with follow-up from January/2014 to May/2017. Analysis involved 48 patients with R/R HL. Those patients received high-dose chemotherapy followed by autologous hemopoietic stem cell transplantation (ASCT). Disease status before ASCT, chemo-mobilization protocols, and stem cell collection and ASCT procedure were recorded. The posttransplantation complications and 30-day mortality were also recorded. Re-evaluation of disease status was done at day 100 post transplantation and the patients were followed up for any evidence of relapse or progression till the end of the study. Comparison of various predictors affecting overall survival (OS) and progression-free survival (PFS) was also performed.RESULTS: The 3-year PFS and OS for the patients with R/R Hodgkin disease who received ASCT were 80% and 70.2%, respectively, with various predictors affecting them. Patients with disease status before ASCT as partial remission and resistant have shorter mean OS and PFS that are not statistically significant (P = 0.325 for OS and 0.45 for PFS). Patients with the number of pretransplant treatment regimens more than 2 have a statistically significant shorter mean PFS and statistically nonsignificant OS (P = 0.4 for OS and 0.06 for PFS). The first 30-day posttransplantation mortality (procedure-related death) was 6.3% due to sepsis.CONCLUSION: The mean PFS was inversely affected by the number of treatment lines received prior to ASCT.