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.
Acknowledgements
We thank San Francisco Edit for editing of our manuscript. Part of the research activities of this study have been made feasible by research grants from Banca del Piemonte and Fondazione Venesio and from Piaggio S.p.A. to CT.
Ethics statement
The study was approved by the ethics committees of the participating centers and authorized by the Clinical Trial Office of IEO (No. 1355).
Author contributions
Concept and design: SV and CT; Data collection: All authors; Statistical analysis and interpretation: SF, VB, SV and CT; Manuscript writing: SV and CT; Manuscript review and approval: All authors; Accountable for all aspects of the work: All authors.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Previous study presentation
This study was presented in part during the 12th International Symposium on Hodgkin Lymphoma (ISHL12), October 22–24, 2022
Data availability statement
The data that support the findings of this study are available from the corresponding author upon request.