We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Long-term outcomes among 2-year survivors of autologous hematopoietic cell transplantation for Hodgkin and diffuse large b-cell lymphoma.
- Authors
Myers, Regina M.; Hill, Brian T.; Shaw, Bronwen E.; Kim, Soyoung; Millard, Heather R.; Battiwalla, Minoo; Majhail, Navneet S.; Buchbinder, David; Lazarus, Hillard M.; Savani, Bipin N.; Flowers, Mary E. D.; D'Souza, Anita; Ehrhardt, Matthew J.; Langston, Amelia; Yared, Jean A.; Hayashi, Robert J.; Daly, Andrew; Olsson, Richard F.; Inamoto, Yoshihiro; Malone, Adriana K.
- Abstract
<bold>Background: </bold>Autologous hematopoietic cell transplantation (auto-HCT) is a standard therapy for relapsed classic Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL); however, long-term outcomes are not well described.<bold>Methods: </bold>This study analyzed survival, nonrelapse mortality, late effects, and subsequent malignant neoplasms (SMNs) in 1617 patients who survived progression-free for ≥2 years after auto-HCT for cHL or DLBCL between 1990 and 2008. The median age at auto-HCT was 40 years; the median follow-up was 10.6 years.<bold>Results: </bold>The 5-year overall survival rate was 90% (95% confidence interval [CI], 87%-92%) for patients with cHL and 89% (95% CI, 87%-91%) for patients with DLBCL. The risk of late mortality in comparison with the general population was 9.6-fold higher for patients with cHL (standardized mortality ratio [SMR], 9.6) and 3.4-fold higher for patients with DLBCL (SMR, 3.4). Relapse accounted for 44% of late deaths. At least 1 late effect was reported for 9% of the patients. A total of 105 SMNs were confirmed: 44 in the cHL group and 61 in the DLBCL group. According to a multivariate analysis, older age, male sex, a Karnofsky score < 90, total body irradiation (TBI) exposure, and a higher number of lines of chemotherapy before auto-HCT were risk factors for overall mortality in cHL. Risk factors in DLBCL were older age and TBI exposure. A subanalysis of 798 adolescent and young adult patients mirrored the outcomes of the overall study population.<bold>Conclusions: </bold>Despite generally favorable outcomes, 2-year survivors of auto-HCT for cHL or DLBCL have an excess late-mortality risk in comparison with the general population and experience an assortment of late complications. Cancer 2018;124:816-25. © 2017 American Cancer Society.
- Subjects
HEMATOPOIETIC stem cells; HODGKIN'S disease; B cells; CANCER research; CANCER invasiveness; CANCER chemotherapy
- Publication
Cancer (0008543X), 2018, Vol 124, Issue 4, p816
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.31114