Achievement of complete remission after autologous stem cell transplantation is strongly corelated with improved survival of patients with Hodgkin lymphoma

Introduction: Several parameters at diagnosis and during autologous stem cell transplant (ASCT) have been reported to influence survival of patients with Hodgkin lymphoma (HL) who underwent ASCT. Methods: This retrospective study included a total of 78 patients (42 males/36 females) who underwent ASCT between 2005 and 2012. All patients were initially treated with ABVD protocol, in relapse/refractory HL with salvage regimens DHAP/ICE, and with BEAM as conditioning regimen before ASCT. Evaluation of disease status was performed according to Cheson criteria. Results: Median age at ASCT was 32 years. Low International Prognostic Score (IPS 0-2) had 21 patients (26.9%), and high (IPS ≥3) had 57 (73.1%). I and II clinical stage according to Ann Arbor had 30 patients (38.5%), while III and IV had 48 (61.5%). Presence of B symptoms had 67 patients (85.9%) and bulky disease 40 (51.3%). Bone marrow infiltration had 3 patients (3.8%). The average of transplanted CD34+ cells in HL patients was 7.45 × 106/kg. After initial chemotherapy complete, partial remission, stable, and progressive disease had 31 patients (39.7%), 9 (11.5%), 24 (30.8%), 14 (17.9%), and after ASCT, 39 (50.0%), 27 (34.6%), 3 (3.8%), and 9 (11.5%), respectively. Of 47 patients, who did not initially achieve complete remission (CR), 22 (46.8%) had CR after ASCT. Median duration of initial event-free survival was 8 months (range, 1-120 months), event-free survival after ASCT was 23.5 months (1-119 months), and overall survival was 72.5 months (12-192 months). Among analyzed parameters, IPS influenced initial event-free (Log Rank = 6.950, P = .008) and event-free survival after ASCT (Log Rank = 3.899, P = .049) as well as overall survival (Log Rank = 3.944, P = .047). Achieving CR after initial chemotherapy influenced duration of initial event-free survival (Log Rank = 17.439, P < .0001), but did not have influence either on event free survival after ASCT or on overall survival (P > .05). However, achievement of CR after ASCT strongly influenced both event-free survival after ASCT (Log Rank = 35.529, P < .0001), and overall survival (Log Rank = 29.182, P < .0001). Conclusions: Our data suggest that achievement of CR after ASCT is one of the major parameters that influence survival of patients who underwent ASCT. Keywords: autologous stem cell transplantation (ASCT); Hodgkin lymphoma (HL)