Long-term results of autologous stem cell transplantation for Hodgkin’s disease (HD) and low-/intermediate-grade B non-Hodgkin’s lymphoma (NHL): a report from the Austrian Stem Cell Transplantation Registry (ASCTR)

Abstract

Between 1990 and 2001, 68 patients with advanced Hodgkin's disease (HD) and 86 patients classified as low-/intermediate-grade B non-Hodgkin's lymphoma (NHL) were reported to the Austrian Stem Cell Transplantation Registry (ASCTR). Following autologous stem cell transplantation (SCT) for HD, overall survival was 56% [95% confidence interval (CI): 40-72%] with a disease-/progression-free survival of 49%, reaching a plateau at 5 years. Using multivariate Cox regression analysis BEAM conditioning (carmustine, cytarabine, etoposide and melphalan) was predictive for favourable outcome, better disease-/progression-free survival and a significantly lower risk for relapse. The cumulative incidence of relapse was 30%, even for patients in complete remission at time of SCT. The cumulative risk for developing a secondary malignancy increased continuously over time, achieving 20% at 7 years and 46% at 10 years with previous radiotherapy as the only risk factor in the multivariate analysis. Overall survival for NHL patients was 45% (95% CI: 26-64%) with a disease-/progression-free survival of 26% at 7 years. In the multivariate Cox regression analysis stage of disease at time of SCT was the most powerful parameter for overall survival, disease-/progression-free survival and relapse. Mantle cell lymphoma, greater than or equal to three lines of previous therapy, and a conditioning regimen other than BEAM were also predictive for death. The main reason for treatment failure was relapse (cumulative incidence 54-75%). Because of the high risk of relapse/progression in both disease categories and the additional high rate of second malignancies in HD patients, allogeneic stem cells should be considered a valuable alternative for selected patients. The efficacy of allotransplantation following reduced-intensity conditioning should be tested in randomised trials.

Evaluation of Autologous Hematopoietic Stem Cell Transplantation Results of the Patients with Hodgkin Lymphoma: A Single Center Experience

“…[4][5][6][7][8][9][10][11][12][13] Unlikely; effects of gender, bone marrow involvement at diagnosis, histology, conditioning regimen, origin of stem cells, mobilization regimen, year of transplantation and immunotherapy were not analyzed in our study. Patient numbers were not enough for making a comparison between groups for some parameters.…”

“…Nachbaur et al 6 found OS was 56% with a disease-/ progression-free survival of 49% following AH-SCT. Majhail et al 21 found OS at 10-years 77%.…”

“…Different studies had different results about remission status and that could be grounded on applying different chemotherapy regimens before transplantation. Nachbaur et al 6 described that incidence of relapse changes according to remission status at transplantation. The cumulative incidence of relapse was 30% even for patients in complete remission at time of AHSCT, 44% for the chemosensitive patients who are not in complete remission and 40% for refractory patients.…”

“…Nachbaur et al 6 described that stage at transplantation was the most powerful parameter affecting OS, DFS and relapse for HL patients who underwent AHSCT. Sureda et al 12 examined the longterm prognostic data in a multivariate analysis, total body irradiation and AHSCT time (before 1995) were identified as independent risk factors for non-relapse mortality.…”

Fosaprepitant for the prevention of nausea and vomiting in patients receiving BEAM or high-dose melphalan before autologous hematopoietic stem cell transplant

“…[29][30][31] Exclusion criteria were a history of allergy to aprepitant or FOS, use of aprepitant during the evaluation period, and pregnancy.…”