Relapse or refractory Hodgkin lymphoma: determining risk of relapse or progression after autologous stem-cell transplantation

Leuk Lymphoma. 2020 Jul;61(7):1548-1554. doi: 10.1080/10428194.2020.1732959. Epub 2020 Mar 9.

Abstract

The treatment of classic Hodgkin lymphoma (HL) is a success in onco-hematology. Despite the high cure rate of HL with initial therapy, 5-10% of patients are primary refractory and 10-20% will eventually relapse. The standard treatment for these patients is salvage chemotherapy and autologous stem cell transplantation (ASCT). Only about half of these patients will benefit from this procedure. The prognosis of relapsed refractory (rr) HL has improved with the introduction of effective drugs. With these options available, identification of reliable risk factors is important to guide treatment over the course of disease. Different variables including performance status, anemia, B symptoms, laboratory abnormalities, treatment intensity before ASCT, response to therapy, and duration of remission, have been analyzed to determine risk for progression-free survival (PFS) and overall survival (OS) after ASCT. This review will discuss the publications analyzing these factors, the validated risk scores useful to identify patients at high risk of progression after ASCT, and will describe future perspectives.

Keywords: Classic Hodgkin lymphoma; prognostic scores post autologous stem cell transplantation; refractory; relapsed; risk factors.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemoradiotherapy
  • Combined Modality Therapy
  • Disease Progression
  • Disease-Free Survival
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hodgkin Disease / pathology
  • Hodgkin Disease / therapy*
  • Humans
  • Neoplasm Recurrence, Local / pathology*
  • Prognosis
  • Risk Factors
  • Salvage Therapy / methods*
  • Transplantation, Autologous
  • Treatment Outcome