Treatment and Prognosis of Relapsed or Refractory Hodgkin Lymphoma Patients Ineligible for Stem Cell Transplantation
Abstract
Relapses occur in 20-30% of patients with Hodgkin lymphoma (HL). Currently, there is no widely accepted standard treatment strategy in relapsed/refractory HL patients ineligible for autologous stem cell transplantation (ASCT).
This article retrospectively evaluates survival and prognosis of patients with relapsed/refractory HL who were not suitable for high-dose chemotherapy and ASCT. New drugs and their effi cacy in this indication are also disscussed.
A total of 17 patients treated with at least three lines of standard chemotherapy +- radiotherapy were analysed. High-dose chemotherapy and ASCT was not indicated due to advanced age (seven patients), chemorefractory disease (seven patients), cardiotoxicity (two patients) and insuffi cient stem cell collection of CD34+ cells (one patient). of four primary chemorefractory patients was signifi cantly worse when compared to the group of 13 relapsed patients: 0 vs. 60.6%, p < 0,001.
Conclusion: Prognosis of relapsed/refractory HL patients ineligible for ASCT and treated with several lines of standard chemotherapy +- radiotherapy is poor. Brentuximab vedotin is indicated in primary refractory patients in the second-line settings and in other relapsed patients in the third-line treatment.
This strategy would help to increase the number of remissions, hence achieving a higher survival rate.