Evaluating outcomes of allo-HSCT for patients with Hodgkin lymphoma

This study evaluated the outcomes of patients with Hodgkin lymphoma (HL) after a first allogeneic hematopoietic stem cell transplant (allo-HSCT). This study concluded that allo-HSCT is promising for these patients, with low relapse rates.

Autologous (auto) HSCT is the usual next step for patients with HL that has come back after initial chemotherapy. This involves transplanting healthy blood cells from the patients after cancer cells have been killed by strong treatment. However, some patients may not be good candidates for this type of transplant. Previous studies suggest that patients with advanced disease or tumors outside of the lymph nodes may have poor outcomes after auto-HSCT.

However, allo-HSCT is another option for these high-risk patients. This procedure involves giving the patient healthy stem cells from a donor. If the donor is a good match, this reduces the chances of graft-versus-host disease (GVHD). This is where the donated stem cells attack the patient’s immune system. GVHD is a common complication of allo-HSCT. The outcomes of allo-HSCT for patients with HL who have not had a transplant before are under investigation.

This study had 31 patients with HL that came back or stopped responding after initial treatment. More than half (77.4%) of patients had 2 or more lines of chemotherapy before the transplant. Of these, 22.6% of patients had no signs of cancer before the transplant. Patients were followed up for 46.9 months after transplantation.

Overall, 80.7% of all patients (25 patients) were still alive 3 years after the transplant. Of these, 21 patients remained cancer-free. 67.7% of patients were still alive 3 years later without tumor growth or spread. 16.1% of all patients had the cancer come back 3 years later.

24 patients had remaining cancer cells present at the time of transplant. However, 70.8% of these patients were still alive 3 years later without tumor growth or spread.

All patients experienced at least one serious side effect. The most common were sore gums and mouth (51.6%), infections (45.2%), and diarrhea (25.8%). 32.3% of patients had a low white blood cell count and developed an infection as a result. Overall, 19.4% of patients developed mild to moderate GVHD. 22.2% of patients developed long-lasting GVHD.

This study concluded that allo-HSCT is promising for patients with HL that has come back or stopped responding to treatment. The authors suggest that this treatment may be effective for high-risk patients who may have poorer outcomes after other therapies.

This was a small study. Larger studies are needed to confirm these results.