Prognostic factors in autologous stem cell transplant on adult patients with Hodgkin lymphoma
2 Haematology Department, Municipal Clinical Hospital №31, St. Petersburg
3 S. Kirov Military Medical Academy, St. Petersburg, Russia
The study was aimed for evaluation of prognostic significance of different factors by event free and overall survival analysis in patients after high dose therapy with stem cells support (HDT/AHSCT).
Patients and methods
Retrospective analysis includes the data of 84 patients with resistant or relapsed Hodgkin lymphoma. Median age was 26.6 years (18-62). Median follow-up is 49 (0.5-115) months. Prognostic factors analyzed included sex, response to the initial chemotherapy, time to relapse, B-symptoms on relapse, serum LDH and albumin levels, response assessed by computer tomography, number of chemotherapy lines before AHSCT, PET-scan results before (PET1) and after (PET2) AHSCT. Survival was estimated using Kaplan-Meier, Cox methods, Chi-square and log-rank test. Results. Four-year overall survival and event-free survival were 70% and 54% respectively (Tables 1, 2). The presented factors had significant value in survival prediction.
In the combined analysis of PET1 and PET2 significant difference observed only in patients with positivity by PET1 and PET2 compared with group with negative PET1 and PET2 results (Tables 3, 4). Conclusion. Our work has revealed that the most significant factors of the event free survival in patients with Hodgkin lymphoma after HDC/AHSCT are: elevation of the LDH activity, В-symptoms, pretreatment, positivity by PET1 and especially lack of response by CT-scan and positivity by PET2.
Hodgkin lymphoma, autologous stem cell transplant, PET, LDH, albumin.
Table 1. Four-year event-free survival (Kaplan-Meier analysis, log-rank test)