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Haematologica. 2016 Apr;101(4):474-81. doi: 10.3324/haematol.2015.136408. Epub 2015 Dec 31.

Single or tandem autologous stem-cell transplantation for first-relapsed or refractory Hodgkin lymphoma: 10-year follow-up of the prospective H96 trial by the LYSA/SFGM-TC study group.

Author information

1
Hématologie, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Sorbonne Paris Cité, Imagine Institute, France david.sibon@aphp.fr.
2
Hôpital Claude Huriez, Lille, France.
3
Hôpital Saint-Louis, AP-HP, Université Paris Diderot, Sorbonne Paris Cité, France.
4
Institut Gustave Roussy, Villejuif, France.
5
Hôpital Henri-Mondor, AP-HP, Université Paris-Est, Créteil, France.
6
Hématologie, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Sorbonne Paris Cité, Imagine Institute, France.
7
Hôpital Cochin, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, France.
8
Institut Paoli-Calmettes, Marseille, France.
9
Centre Léon Bérard, Lyon; and Université Claude-Bernard Lyon 1, Pierre-Bénite, France.
10
Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Université Claude-Bernard Lyon 1, Pierre-Bénite, France.

Abstract

We assessed the long-term results of autologous stem-cell transplantation for patients with first-relapsed or refractory Hodgkin lymphoma included in the prospective Lymphoma Study Association/Société Française de Greffe de Moelle H96 trial. This large multicenter phase II trial evaluated a risk-adapted strategy with single or tandem autologous stem-cell transplantation for 245 Hodgkin lymphoma patients. Poor-risk patients (n=150) had primary refractory Hodgkin lymphoma (n=77) or ≥2 risk factors at first relapse (n=73) and were eligible for tandem autologous stem-cell transplantation. Intermediate-risk patients (n=95) had one risk factor at first relapse and were eligible for single autologous stem-cell transplantation. With a median follow-up of 10.3 years, 10-year freedom from second failure and overall survival rates were, respectively: 64% (95% CI, 54% to 74%) and 70% (95% CI, 61% to 80%) for the intermediate-risk group, and 41% (95% CI, 33% to 49%) and 47% (95% CI, 39% to 55%) for the poor-risk group. Considering only patients who did not relapse after completing autologous stem-cell transplantation, the 15-year cumulative incidences of second primary malignancies were 24% for the 70 intermediate-risk patients and 2% for the 75 poor-risk ones. With long-term follow-up, the risk-adapted strategy remains appropriate. Tandem autologous stem-cell transplantation can still be considered an option for poor-risk patients, but integration of positron-emission tomography findings and new drugs may help to refine the need for a second autologous stem-cell transplant and possibly improve outcomes of patients with first-relapsed or refractory Hodgkin lymphoma.

PMID:
26721893
PMCID:
PMC5004408
DOI:
10.3324/haematol.2015.136408
[Indexed for MEDLINE]
Free PMC Article

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