Outcome of children and adolescents with relapsed Hodgkin lymphoma treated with high-dose therapy and autologous stem cell transplantation: the Memorial Sloan Kettering Cancer Center experience

Leuk Lymphoma. 2018 Aug;59(8):1861-1870. doi: 10.1080/10428194.2017.1403601. Epub 2017 Nov 29.

Abstract

To evaluate outcomes and prognostic markers among children with relapsed Hodgkin lymphoma (HL) treated with autologous stem cell transplant (ASCT), we conducted a retrospective analysis of 36 consecutive pediatric patients treated at Memorial Sloan Kettering Cancer Center from 1989 to 2013. With a median follow-up of 9.6 years, the 10-year overall survival (OS) and event-free survival (EFS) were 74.1 and 67.1% respectively. Absence of B-symptoms, chemotherapy-sensitive disease, and transplant date after 1997 were each associated with superior EFS [HR 0.12 (p = .0015), 0.18 (p = .0039), and 0.17 (p = .0208), respectively]. Childhood Hodgkin International Prognostic Score at relapse (R-CHIPS) was calculated in a subset of patients (n = 22) and a lower score was associated with improved OS (HR 0.29, p = .0352) and a trend toward improved EFS (HR 0.38, p = .0527). In summary, ASCT results in durable remission for the majority of pediatric patients with relapsed HL. R-CHIPS should be evaluated in larger cohorts as a potential predictive tool.

Keywords: Clinical results; lymphoma and Hodgkin disease; marrow and stem cell transplantation; neoplasia; prognostication.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Dose-Response Relationship, Drug
  • Female
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hodgkin Disease / pathology
  • Hodgkin Disease / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Neoplasm Recurrence, Local
  • Prognosis
  • Retrospective Studies
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult