High-dose chemotherapy and autologous stem cell transplant in adolescent patients with relapsed or refractory Hodgkin's lymphoma

Fifty-eight adolescent patients with relapsed or primary refractory Hodgkin's lymphoma underwent high-dose chemotherapy (HDC) and autologous SCT (ASCT). The median age at ASCT was 17 years (range 14-21). The disease had relapsed in 24 patients (41) and was refractory to initial chemotherapy in 34 (59). ESHAP salvage chemotherapy before ASCT resulted in 88 response. After ASCT, complete remission (CR; including CR-unconfirmed) was seen in 41 patients (71) and partial remission in 7 (12). The overall response rate was 83. One patient did not respond and nine (15) had progressive disease. Three more patients achieved CR after consolidative radiation post-ASCT. There was no transplant-related mortality. At a median follow-up of 43 months from ASCT, 31 patients (53) are alive in CR, 5 (9) are alive with disease and 22 (38) have died (21 from disease and 1 unrelated). The actuarial probabilities of event-free and overall (OS) survival are 45 and 55 at 11 years. The only negative prognostic factor for OS was the presence of B symptom at relapse or progression (11-year OS 27 vs 60, P0.003). © 2010 Macmillan Publishers Limited.