ROLE OF AUTOLOGOUS STEM CELL TRANSPLANTATION IN RELAPSED/ REFRACTORY HODGKIN'S LYMPHOMA: RETROSPECTIVE DATA FROM A TERTIARY CARE CENTRE IN INDIA

Hodgkin Lymphoma is a highly curable malignancy, and relapsed/refractory Hodgkin lymphoma (RRHL) is treated with salvage chemotherapy, followed by autologous stem cell transplant (ASCT). This single-center, retrospective study included patients with RRHL who underwent ASCT. The study included 62 patients with a median age at diagnosis of 22.5 years and a median age at transplant of 24.5 years. Advanced disease at presentation was observed in 64% of the patients. At relapse, 33.3%, 36.6%, and 30% had stage 2, 3, and 4 disease, respectively. Multiple salvage regimens were administered as per the practices at our institution. Among the patients, 63% had complete remission prior to transplant, and 74% underwent ASCT after first-line salvage. Different conditioning regimens were chosen according to institutional practice. Febrile neutropenia was observed in 93.5% of the patients. The treatment-related mortality rate was 4.8% (n=3). The median follow-up duration was 30 months. Median relapse-free survival (RFS) and overall survival (OS) were not reached, and the 3-year RFS and OS rates were 67.1% and 78%, respectively. Factors that adversely influenced OS and RFS were the type of last salvage used and the number of salvage lines prior to transplantation. An advanced stage at the diagnosis was associated with inferior OS but not with RFS. Patients with the refractory disease had inferior RFS and OS rates, of 25.2% and 56.6%, compared with patients with chemoresponsive disease, who had RFS and OS rates of 77% and 84.7%, respectively. ASCT in RRHL showed promising survival, with over two-thirds of the patients surviving without relapse after 3 years.