Evaluation of prognostic factors in patients with high-risk classical Hodgkin lymphoma undergoing autologous transplantation

There are limited data assessing the risk scores for primary treatment failure (PTF) in patients with classical Hodgkin lymphoma (cHL; PTF-cHL) undergoing autologous hematopoietic cell transplantation (auto-HCT). ECLIPSE (Evaluation of Classical Hodgkin Lymphoma patients wIth Primary treatment failure and analySis of outcomEs) is a multicenter retrospective cohort of patients with PTF-cHL (aged ≥15 years) diagnosed on or after 1 January 2005, at 15 US medical centers. PTF was defined as 1 of the following patterns of failure: (1) progressive disease by imaging during or within 6 weeks of completion of frontline chemotherapy (primary progression [PP]); (2) partial response (PR) or stable disease (SD) by imaging after completion of frontline treatment (PR/SD); (3) progression of disease by imaging (and confirmed by biopsy) within 12 months of frontline therapy completion after prior documentation of complete response (CR; early relapse [ER]). A total of 478 patients were included in the analysis. Among these, 217 (45%) were PP, 86 (18%) were PR/SD, and 175 (37%) were ER. The 6-month and 1-year cumulative incidence of nonrelapse mortality after auto-HCT were 0.9% and 1.1%, respectively. The median progression-free survival (PFS) and overall survival (OS) after auto-HCT were 4.33 and 10.09 years, respectively. Although those not in CR at the time of auto-HCT were associated with inferior PFS and OS, advanced age and diagnosis before 2011 were associated with inferior OS. This study showcases the safety and long-term efficacy of auto-HCT, even in patients with high-risk disease who are traditionally considered chemotherapy refractory, and will serve as a benchmark for the ongoing transplant vs no transplant trials.

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Publication Details

Journal
Blood Advances
Published
2024-08-30
DOI
https://doi.org/10.1182/bloodadvances.2024013743
Citations
6
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
2.55
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article

Evaluation of prognostic factors in patients with high-risk classical Hodgkin lymphoma undergoing autologous transplantation

Reem Karmali, Frederick Lansigan, Jakub Svoboda, Luciano J. Costa et al.
6 citations
Blood Advances
Lymphoma Diagnosis and Treatment
2.55
article

Evaluation of prognostic factors in patients with high-risk classical Hodgkin lymphoma undergoing autologous transplantation

Reem Karmali, Frederick Lansigan, Jakub Svoboda, Luciano J. Costa, Jonathon Brett Cohen, Mehdi Hamadani, John L Vaughn, Paolo F. Caimi, Stefan Klaus Barta, Amanda F. Cashen, Alex Francisco Herrera, Walter Hanel, Caryn Sorge, Francisco J. Hernandez‐Ilizaliturri, Shalin Kothari, Talha Badar, Ying Huang, Julio C. Chávez, Nishitha Reddy, Narendranath Epperla, Tarsheen Sethi, Ana C. Xavier, Beth Christian, Celeste Bello, Martha Glenn
article en
6 citations

Abstract

There are limited data assessing the risk scores for primary treatment failure (PTF) in patients with classical Hodgkin lymphoma (cHL; PTF-cHL) undergoing autologous hematopoietic cell transplantation (auto-HCT). ECLIPSE (Evaluation of Classical Hodgkin Lymphoma patients wIth Primary treatment failure and analySis of outcomEs) is a multicenter retrospective cohort of patients with PTF-cHL (aged ≥15 years) diagnosed on or after 1 January 2005, at 15 US medical centers. PTF was defined as 1 of the following patterns of failure: (1) progressive disease by imaging during or within 6 weeks of completion of frontline chemotherapy (primary progression [PP]); (2) partial response (PR) or stable disease (SD) by imaging after completion of frontline treatment (PR/SD); (3) progression of disease by imaging (and confirmed by biopsy) within 12 months of frontline therapy completion after prior documentation of complete response (CR; early relapse [ER]). A total of 478 patients were included in the analysis. Among these, 217 (45%) were PP, 86 (18%) were PR/SD, and 175 (37%) were ER. The 6-month and 1-year cumulative incidence of nonrelapse mortality after auto-HCT were 0.9% and 1.1%, respectively. The median progression-free survival (PFS) and overall survival (OS) after auto-HCT were 4.33 and 10.09 years, respectively. Although those not in CR at the time of auto-HCT were associated with inferior PFS and OS, advanced age and diagnosis before 2011 were associated with inferior OS. This study showcases the safety and long-term efficacy of auto-HCT, even in patients with high-risk disease who are traditionally considered chemotherapy refractory, and will serve as a benchmark for the ongoing transplant vs no transplant trials.

Blood AdvancesVol. 8(21)
Northwestern University (US), Dartmouth–Hitchcock Medical Center (US), Fox Chase Cancer Center (US), Roswell Park Comprehensive Cancer Center (US), City Of Hope National Medical Center (US), Cleveland Clinic (US), Long Island University (US), University of Kentucky (US), Emory University (US), Medical College of Wisconsin (US), Washington University in St. Louis (US), University of Utah (US), Hospital of the University of Pennsylvania (US), The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US), Huntsman Cancer Institute (US), Jacksonville College (US), WinnMed (US), Moffitt Cancer Center (US), University of Alabama at Birmingham (US), Yale University (US), City of Hope (US), Dartmouth Psychiatric Research Center (US), Mayo Clinic in Florida (US), Smilow Cancer Hospital (US), Dartmouth Cancer Center, The Ohio State University (US), Case Western Reserve University (US), University of Pennsylvania (US), Vanderbilt University Medical Center (US)
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Lymphoma Diagnosis and Treatment
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