A cure rate survival model after stem cell transplantation for relapsed or refractory Hodgkin lymphoma patients.

Abstract

Hodgkin lymphoma (HL) is one of the best curable malignancies. Randomized controlled studies have validated the benefit of hematopoietic stem cell transplant (HSCT) for patients with relapsed or primary refractory HL. This analysis aimed to identify significant prognostic factors on the recurrence of the disease after HSCT by applying a cure rate model. There were 92 patients with HL in this retrospective study who underwent HSCT from 2007 up to 2014 with 18 months follow-up in Tehran, Iran. The survival time was set as the time interval between transplantation and the recurrence of HL. Also, hyper-Poisson distribution was used as discrete frailty to account the unobserved heterogeneity and random effects. In noncured cases, the mean of survival time was 318 (95% confidence interval, 144-493) days. The 1-, 3- and 5-year survival rates were 88.9%, 83.4%, and 80.7%, respectively. A significant association was observed between cured patients and the variables such as age, the experience of pre-transplantation relapse, hemoglobin (Hb), mononuclear cells (MNCs), and body surface area (BSA) at the time of transplantation. The study concluded that patients with less than thirty years of age, a high level of Hb (g/dl), a low level of MNCs and BSA (m2), and the absence of pre-transplantation experience of relapse were associated with better survival after HSCT. Based on this study, post-transplant consolidation therapies could be considered for the treatment of HL patients after HSCT.

Publication
Middle East Journal of Cancer