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Outcome of autologous hematopoietic stem cell transplantation in children and adolescents with relapsed or refractory Hodgkin's lymphoma

Authors :
Haldun Öniz
Nurdan Tacyildiz
Akif Yeşilipek
Vural Kesik
Murat Elli
Ekrem Unal
Şebnem Yılmaz Bengoa
Alphan Kupesiz
Ülker Koçak
Fatih Erbey
Gulsun Karasu
Didem Atay
Erman Ataş
Serap Aksoylar
Emel Ünal
Savaş Kansoy
Vedat Uygun
Musa Karakukcu
Atila Tanyeli
Gülay Sezgin
Zühre Kaya
Nilgun Kurucu
Gülyüz Öztürk
Volkan Hazar
Sema Anak
Ondokuz Mayıs Üniversitesi
Çukurova Üniversitesi
Source :
Pediatric transplantation. 19(7)
Publication Year :
2015

Abstract

This study evaluates the outcome of 66 pediatric patients with rrHL who underwent autoHSCT. Twenty-nine patients experienced early relapse, and 19 patients experienced late relapse. Of 18 newly diagnosed with HL, 13 were primary refractory disease and five had late responsive disease. At the time of transplantation, only 68% of the patients were chemosensitive. The majority of patients received BCNU+etoposide+ara-C+melphalan for conditioning (45/66), and peripheral blood (56/66) was used as a source of stem cells. After a median follow-up period of 39months, 46 patients were alive. At fiveyr, the probabilities of OS, EFS, the relapse rate, and the non-relapse mortality rate were 63.1%, 54.3%, 36.4%, and 9.1%, respectively. The probability of EFS in chemosensitive and chemoresistant patients at fiveyr was 72.3% and 19%, respectively (p<br />This study evaluates the outcome of 66 pediatric patients with rrHL who underwent autoHSCT. Twenty-nine patients experienced early relapse, and 19 patients experienced late relapse. Of 18 newly diagnosed with HL, 13 were primary refractory disease and five had late responsive disease. At the time of transplantation, only 68% of the patients were chemosensitive. The majority of patients received BCNU + etoposide + ara-C + melphalan for conditioning (45/66), and peripheral blood (56/66) was used as a source of stem cells. After a median follow-up period of 39 months, 46 patients were alive. At five yr, the probabilities of OS, EFS, the relapse rate, and the non-relapse mortality rate were 63.1%, 54.3%, 36.4%, and 9.1%, respectively. The probability of EFS in chemosensitive and chemoresistant patients at five yr was 72.3% and 19%, respectively (p < 0.001). Multivariate analysis showed that chemoresistant disease at the time of transplantation was the only factor predicting limited both OS (hazard ratio = 4.073) and EFS (hazard ratio = 4.599). AutoHSCT plays an important role for the treatment of rrHL in children and adolescents, and survival rates are better for patients with chemosensitive disease at the time of transplantation.

Details

ISSN :
13993046
Volume :
19
Issue :
7
Database :
OpenAIRE
Journal :
Pediatric transplantation
Accession number :
edsair.doi.dedup.....8b1dcadb612469150915511eaf37ead3