Evaluation of prognostic factors in patients with high-risk classical Hodgkin lymphoma undergoing autologous transplantation

Narendranath Epperla, Ying Huang, Amanda F. Cashen, John L. Vaughn, Walter Hanel, Talha Badar, Stefan K. Barta, Paolo F. Caimi, Tarsheen K. Sethi, Nishitha Reddy, Reem Karmali, Celeste Bello, Julio C. Chavez, Shalin K. Kothari, Francisco J. Hernandez-Ilizaliturri, Jakub Svoboda, Frederick Lansigan, Martha J. Glenn, Jonathon B. Cohen, Caryn SorgeBeth Christian, Alex F. Herrera, Mehdi Hamadani, Luciano J. Costa, Ana C. Xavier

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

There are limited data assessing the risk scores for primary treatment failure (PTF) in patients with classical Hodgkin lymphoma (cHL; PTF-cHL) undergoing autologous hematopoietic cell transplantation (auto-HCT). ECLIPSE (Evaluation of Classical Hodgkin Lymphoma patients wIth Primary treatment failure and analySis of outcomEs) is a multicenter retrospective cohort of patients with PTF-cHL (aged ≥15 years) diagnosed on or after 1 January 2005, at 15 US medical centers. PTF was defined as 1 of the following patterns of failure: (1) progressive disease by imaging during or within 6 weeks of completion of frontline chemotherapy (primary progression [PP]); (2) partial response (PR) or stable disease (SD) by imaging after completion of frontline treatment (PR/SD); (3) progression of disease by imaging (and confirmed by biopsy) within 12 months of frontline therapy completion after prior documentation of complete response (CR; early relapse [ER]). A total of 478 patients were included in the analysis. Among these, 217 (45%) were PP, 86 (18%) were PR/SD, and 175 (37%) were ER. The 6-month and 1-year cumulative incidence of nonrelapse mortality after auto-HCT were 0.9% and 1.1%, respectively. The median progression-free survival (PFS) and overall survival (OS) after auto-HCT were 4.33 and 10.09 years, respectively. Although those not in CR at the time of auto-HCT were associated with inferior PFS and OS, advanced age and diagnosis before 2011 were associated with inferior OS. This study showcases the safety and long-term efficacy of auto-HCT, even in patients with high-risk disease who are traditionally considered chemotherapy refractory, and will serve as a benchmark for the ongoing transplant vs no transplant trials.

Original languageEnglish
Pages (from-to)5458-5466
Number of pages9
JournalBlood Advances
Volume8
Issue number21
DOIs
StatePublished - Nov 12 2024

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