Annals of Hematology

, Volume 93, Issue 10, pp 1745–1753

ESHAP as salvage therapy for relapsed or refractory Hodgkin’s lymphoma

  • Jorge Labrador
  • Mónica Cabrero-Calvo
  • Estefanía Pérez-López
  • María Victoria Mateos
  • Lourdes Vázquez
  • María Dolores Caballero
  • Ramón García-Sanz
Original Article

DOI: 10.1007/s00277-014-2114-0

Cite this article as:
Labrador, J., Cabrero-Calvo, M., Pérez-López, E. et al. Ann Hematol (2014) 93: 1745. doi:10.1007/s00277-014-2114-0

Abstract

The management of relapsed or refractory Hodgkin’s lymphoma (RR-HL) remains a challenge for hematologists and oncologists. Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care for RR-HL. However, one of the most controversial aspects is which the best salvage protocol could be. We retrospectively analyzed 82 consecutive RR-HL who received etoposide, steroids, ara-C, and cisplatin (ESHAP) as salvage therapy followed by ASCT. Fifty percent of patients were refractory and 23 % early relapses. Overall response rate (ORR) was 67 % (50 % complete remission (CR)). Ninety one percent of patients (75/82) were transplanted. With a mean follow-up of 87 ± 53 months, the median progression-free survival (PFS) and time to tumor progression (TTP) for the whole population were 52 and 56 months, respectively, and the 5-year overall survival was 72.6 %. Achieving CR after ESHAP was associated with a longer PFS (78 vs 16 % 5-year PFS, respectively, P < 0.01) and TTP (80 vs 19 % 5-year TTP, respectively, P < 0.01). However, there were no differences for overall survival (OS) when comparing CR and partial response (PR) after ESHAP. Toxicity was low and <10 % of patients developed neutropenic fever, with no toxic deaths. Mobilization was possible in 94 % of patients. ESHAP is a safe and efficient therapeutic option for patients with RR-HL who are candidates for ASCT, since it combines a high response rate and mobilizing potential with a low toxicity profile.

Keywords

Hodgkin’s lymphomaRelapseRefractoryESHAPSalvage therapyAutologous stem cell transplant

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Jorge Labrador
    • 1
  • Mónica Cabrero-Calvo
    • 1
  • Estefanía Pérez-López
    • 1
  • María Victoria Mateos
    • 1
  • Lourdes Vázquez
    • 1
  • María Dolores Caballero
    • 1
  • Ramón García-Sanz
    • 1
  1. 1.Department of HematologyUniversity Hospital of SalamancaSalamancaSpain