Relapse or refractory Hodgkin lymphoma: determining risk of relapse or progression after autologous stem-cell transplantation

Abstract

The treatment of classic Hodgkin lymphoma (HL) is a success in onco-hematology. Despite the high cure rate of HL with initial therapy, 5–10% of patients are primary refractory and 10–20% will eventually relapse. The standard treatment for these patients is salvage chemotherapy and autologous stem cell transplantation (ASCT). Only about half of these patients will benefit from this procedure. The prognosis of relapsed refractory (rr) HL has improved with the introduction of effective drugs. With these options available, identification of reliable risk factors is important to guide treatment over the course of disease. Different variables including performance status, anemia, B symptoms, laboratory abnormalities, treatment intensity before ASCT, response to therapy, and duration of remission, have been analyzed to determine risk for progression-free survival (PFS) and overall survival (OS) after ASCT. This review will discuss the publications analyzing these factors, the validated risk scores useful to identify patients at high risk of progression after ASCT, and will describe future perspectives.

Keywords:

• Classic Hodgkin lymphoma
• relapsed
• refractory
• risk factors
• prognostic scores post autologous stem cell transplantation

Acknowledgements

The authors are indebted to hematologists, the transplant department and pathologists in FUNDALEU for the dedication and expertise always shown in the care of our patients and the sustained scientific collaboration.

Disclosure statement

The authors declare no conflict of interest.