Survival after autologous versus allogeneic transplantation in patients with relapsed and refractory Hodgkin lymphoma

Leuk Lymphoma. 2021 Oct;62(10):2408-2415. doi: 10.1080/10428194.2021.1927016. Epub 2021 May 14.

Abstract

For relapsed Hodgkin lymphoma, salvage chemotherapy followed by auto-HCT is the standard of care. It is important to identify subpopulations who could benefit from allo-HCT. This retrospective analysis included 277 patients with rrHL who underwent first transplant with auto-HCT or allo-HCT between 2007-2017. Patients in the auto-HCT cohort (N = 218) were older, more likely to be in CR at the time of transplant and receive maintenance therapy post-transplant. Patients who underwent allo-HCT (N = 59) had a higher MSKCC relapse score. Factors associated with an inferior PFS and OS included early relapse, advanced stage, extranodal involvement and not achieving CR following salvage chemotherapy. After controlling for these 4 risk factors and MSKCC score, PFS (p = 0.112) or OS (p = 0.256) was not affected by the choice of transplant. In patients with ≥ 3 high risk features, the 4-year PFS was 51% in the allo-HCT vs. 39% (p = 0.107) in the auto-HCT cohort.

Keywords: Autologous hematopoietic cell transplantation; allogeneic hematopoietic cell transplantation; relapsed Hodgkin lymphoma.

MeSH terms

  • Hematopoietic Stem Cell Transplantation*
  • Hodgkin Disease* / therapy
  • Humans
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Transplantation, Homologous