1. High-dose chemotherapy and autologous stem cell transplant as first salvage treatment for relapsed or refractory Hodgkin Lymphoma in the era of PET-adapted strategies
- Author
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Viviani, S, Vanazzi, A, Frassoni, S, Rusconi, C, Rossi, A, Romano, A, Patti, C, Schiavotto, C, Sorasio, R, Marasco, V, Lissandrini, L, Rapezzi, D, Gottardi, D, Cocito, F, Mule, A, Leotta, S, Gini, G, Sorio, M, Derenzini, E, Rambaldi, A, Bagnardi, V, Tarella, C, Viviani S., Vanazzi A., Frassoni S., Rusconi C., Rossi A., Romano A., Patti C., Schiavotto C., Sorasio R., Marasco V., Lissandrini L., Rapezzi D., Gottardi D., Cocito F., Mule A., Leotta S., Gini G., Sorio M., Derenzini E., Rambaldi A., Bagnardi V., Tarella C., Viviani, S, Vanazzi, A, Frassoni, S, Rusconi, C, Rossi, A, Romano, A, Patti, C, Schiavotto, C, Sorasio, R, Marasco, V, Lissandrini, L, Rapezzi, D, Gottardi, D, Cocito, F, Mule, A, Leotta, S, Gini, G, Sorio, M, Derenzini, E, Rambaldi, A, Bagnardi, V, Tarella, C, Viviani S., Vanazzi A., Frassoni S., Rusconi C., Rossi A., Romano A., Patti C., Schiavotto C., Sorasio R., Marasco V., Lissandrini L., Rapezzi D., Gottardi D., Cocito F., Mule A., Leotta S., Gini G., Sorio M., Derenzini E., Rambaldi A., Bagnardi V., and Tarella C.
- Abstract
Data on the efficacy of high-dose chemotherapy and autologous stem cell transplantation (ASCT) for classical Hodgkin lymphoma (cHL) patients who failed a PET-driven first-line therapy are limited. We retrospectively evaluated 220 adult cHL patients who underwent ASCT from 2009 to 2021 at 11 centers in Italy. Overall, 49.5% had refractory disease, 23.2% relapsed < 12 and 27.3% ≥12 months from the end of first-line chemotherapy. The 3-year progression-free survival (PFS) and overall survival (OS) were 73.8% and 89.4%. In univariable analysis for PFS events PET-2+ (HR 2.69, p =.001), anemia (HR 2.22, p =.019), refractory disease (HR 1.76, p =.045), less than CR before ASCT (HR 3.24, p <.001) and >2 lines of salvage therapy (HR 2.52; p =.004) were associated with a higher risk of failure after ASCT. In multivariable analysis, >2 lines of salvage therapy (HR 3.28, p =.004) and RT before ASCT (HR 3.00, p = 0.041) retained significance. ASCT is an effective salvage approach for cHL patients treated in the era of PET-adapted therapies.
- Published
- 2024