In a nutshell
This study investigated the outcomes of umbilical cord blood transplantation in pretreated patients with Hodgkin’s lymphoma. The authors concluded that this procedure is a feasible treatment option for these patients.
Some background
Patients with relapsed or refractory (does not respond to treatment) Hodgkin’s lymphoma have limited treatment options. High-dose chemotherapy followed by autologous stem cell transplantation (using stem cells harvested from the patient) can improve survival. However, up to 50% of patients experience relapse or disease progression after this treatment.
Umbilical cord blood transplantation is another transplant option. After chemotherapy, stem cells from donated umbilical cord blood are introduced to the patient. The impact of this procedure on the outcomes of patients with Hodgkin’s lymphoma remain under investigation.
Methods & findings
This study included information on 131 adults with Hodgkin’s lymphoma. All patients underwent umbilical cord blood transplantation. Patients had an average of 4 lines of previous chemotherapy. 47% of patients were in complete remission at the time of transplant. The average follow-up period was 55 months.
Four-year progression-free survival (PFS; patients alive without a return of disease) was 26%. Four-year overall survival (OS; patients still alive 4 years later) was 46%. Patients who were in remission at the time of transplant had significantly higher PFS (62%) and OS (38%) than those who were not.
26% of patients developed acute graft-versus-host disease (donated cells attack the patient’s healthy cells) 100 days after treatment. 25.2% of patients developed chronic (persistent for a long time) graft-versus-host disease 163 days after treatment. This increased to 32% after four years.
42.7% of patients relapsed at an average of 6 months after treatment. This increased to 44% after 4 years.
Having relapsed or refractory disease prior to transplantation was significantly associated with poor survival outcomes. These included higher odds of relapse (3.14-fold), lower progression-free survival (3.45-fold), and lower overall survival (3.10-fold).
The bottom line
This study concluded that this procedure is a feasible treatment option for patients with Hodgkin’s lymphoma, especially those who already received multiple treatments.
The fine print
This study was retrospective, meaning it looked back in time to analyze patient data.
Published By :
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Date :
Jul 18, 2018
