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Posted by on Apr 15, 2019 in Hodgkin's lymphoma | 0 comments

In a nutshell

This study evaluated the long-term outcomes of patients with recurrent or non-responsive classical Hodgkin’s lymphoma (cHL) after undergoing radiation, chemotherapy, and autologous stem cell transplantation (autoSCT). This study concluded that total lymphoid irradiation (TLI) therapy before a bone marrow transplant can improve long-term survival outcomes for these patients.

Some background

Recurrent or unresponsive cHL remains challenging to treat. High-dose chemotherapy followed by a bone marrow transplant has been shown to improve survival outcomes for these patients. Radiation therapy may also be given after the transplant to help keep the cancer from coming back.

There are 2 main types of radiation therapy (RT). Involved-field RT targets specific areas of the body. This is a local radiation treatment. Total lymphoid irradiation (TLI) is a more widespread treatment. The long-term outcomes of TLI after autoSCT for patients with recurrent or unresponsive cHL remain under investigation.

Methods & findings

This study involved 89 patients with recurrent or unresponsive cHL. All patients received high-dose chemotherapy followed by radiation therapy. Then, patients underwent autoSCT. Patients were followed-up for an average of 4 years. Patients had PET/CT scans before and after treatment.

After chemotherapy, 50.6% of patients had a disappearance of all signs of cancer (complete response). Overall, patients survived for an average of 47.9 months after transplant. At 5 years, 72.8% of patients were still alive. At 10 years, this rate was 68.0%. 73.3% of patients were still alive 5 years later without tumor growth or spread. At 10 years, this rate was 68.5%.

Significantly more patients who had a complete response were still alive 5 years later compared to patients who did not (90.0% vs. 63.5%). At 10 years, this rate was 90.9% vs. 57.6%. Achieving a complete response after chemotherapy was associated with a 92% lower risk of mortality, and an 82% lower risk of tumor growth or spread.

Overall, 22.5% of patients experienced treatment failure at an average of 6.1 months after transplant. At an average of 5.6 years after transplant, 8 patients developed secondary cancer.

The bottom line

This study concluded that TLI therapy before a bone marrow transplant can improve long-term survival outcomes for patients with recurrent or unresponsive cHL.

The fine print

This study was retrospective, meaning it looked back in time to analyze data. Also, this study involved a small number of patients. More studies are needed to confirm these results.

Published By :

International journal of radiation oncology, biology, physics

Date :

Feb 11, 2019

Original Title :
Patterns of Failure and Survival Outcomes After Total Lymphoid Irradiation and High-Dose Chemotherapy With Autologous Stem Cell Transplantation for Relapsed or Refractory Classical Hodgkin Lymphoma.
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