Survival after autologous versus allogeneic transplantation in patients with relapsed and refractory Hodgkin lymphoma

Abstract

For relapsed Hodgkin lymphoma, salvage chemotherapy followed by auto-HCT is the standard of care. It is important to identify subpopulations who could benefit from allo-HCT. This retrospective analysis included 277 patients with rrHL who underwent first transplant with auto-HCT or allo-HCT between 2007–2017. Patients in the auto-HCT cohort (N = 218) were older, more likely to be in CR at the time of transplant and receive maintenance therapy post-transplant. Patients who underwent allo-HCT (N = 59) had a higher MSKCC relapse score. Factors associated with an inferior PFS and OS included early relapse, advanced stage, extranodal involvement and not achieving CR following salvage chemotherapy. After controlling for these 4 risk factors and MSKCC score, PFS (p = 0.112) or OS (p = 0.256) was not affected by the choice of transplant. In patients with ≥ 3 high risk features, the 4-year PFS was 51% in the allo-HCT vs. 39% (p = 0.107) in the auto-HCT cohort.

Keywords:

• Autologous hematopoietic cell transplantation
• allogeneic hematopoietic cell transplantation
• relapsed Hodgkin lymphoma

Author contributions

B.F. designed research, performed research, analyzed data and wrote the paper.

E.Y. performed research and analyzed data.

F.G. analyzed data.

R.F.A. designed research and reviewed the paper.

R.J. designed research and reviewed the paper.

N.L.B. designed research and reviewed the paper.

A.C. designed research, reviewed the paper and jointly supervised the work with N.W.J. (co-senior author)

N.W.J. designed research, reviewed the paper and jointly supervised the work with A.C. (co-senior author).

Disclosure statement

None of the authors has a relevant conflict of interest.