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Autologous hematopoietic stem cell transplantation in classical Hodgkin's lymphoma

DOI: 10.5581/1516-8484.20110007

Keywords: hodgkin's lymphoma, hematopoietic stem cell transplantation, autologous transplantation, doxorubicin, bleomycynm, vinblastine, dacarbazine, study retrospective.

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Abstract:

background: hodgkin's lymphoma has high rates of cure, but in 15% to 20% of general patients and between 35% and 40% of those in advanced stages, the disease will progress or will relapse after initial treatment. for this group, hematopoietic stem cell transplantation is considered one option of salvage therapy. objectives: to evaluate a group of 106 patients with hodgkin's lymphoma, who suffered relapse or who were refractory to treatment, submitted to autologous hematopoietic stem cell transplantation in a single transplant center. methods: a retrospective study was performed with data collected from patient charts. the analysis involved 106 classical hodgkin's lymphoma patients who were consecutively submitted to high-dose chemotherapy followed by autologous transplants in a single institution from april 1993 to december 2006. results: the overall survival rates of this population at five and ten years were 86% and 70%, respectively. the disease-free survival was approximately 60% at five years. four patients died of procedure-related causes but relapse of classical hodgkin's lymphoma after transplant was the most frequent cause of death. univariate analysis shows that sensitivity to pre-transplant treatment and hemoglobin < 10 g/dl at diagnosis had an impact on patient survival. unlike other studies, b-type symptoms did not seem to affect overall survival. lactic dehydrogenase and serum albumin concentrations analyzed at diagnosis did not influence patient survival either. conclusion: autologous hematopoietic stem cell transplantation is an effective treatment strategy for early and late relapse in classical hodgkin's lymphoma for cases that were responsive to pre-transplant chemotherapy. refractory to treatment is a sign of worse prognosis. additionally, a hemoglobin concentration below 10 g/dl at diagnosis of hodgkin's lymphoma has a negative impact on the survival of patients after transplant. as far as we know this relationship has not been previously report

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