Three-year overall survival (OS) increased from 50% to 84% in reduced-intensity conditioning (RIC) hematopoietic cell transplantation (HCT) for relapsed/refractory Hodgkin lymphoma in the time periods 2000-2008 compared to 2009-2013, according to a single-center retrospective study of 72 patients.
In the recent period, patients who more often received brentuximab vedotin (BV, 60% vs. 2%), had fewer comorbidities (HCT comorbidity index 0: 60% vs. 12%) and were in complete remission (50% vs. 23%) prior to undergoing HCT. Three-year progression-free survival (PFS) rates doubled for patients treated between 2009 and 2013 (49%, 95% CI 26-68%) when compared with the earlier era (23%, 95% CI 13-35%, p=0.02).
In a multivariate analysis, mortality was higher among those with chemoresistance (HR 3.83, 95% CI 1.38-10.57), while treatment during the recent era was associated with better OS (HR for period 2009-2013: 0.24, 95% CI 0.07-0.79) and PFS (HR 0.46, 95% CI 0.23-0.92).
Researchers attributed the increase in survival to improved disease control prior to HCT. They noted that the decreased morbidity and mortality after allogeneic HCT in HL is likely due to RIC regimens, advances in supportive care and improved strategies to prevent graft-versus-host disease.
Hegerova L, et al. Bone Marrow Transplant