Annals of Hematology

, Volume 84, Issue 7, pp 462–473

Long-term results of autologous stem cell transplantation for Hodgkin’s disease (HD) and low-/intermediate-grade B non-Hodgkin’s lymphoma (NHL): a report from the Austrian Stem Cell Transplantation Registry (ASCTR)

  • David Nachbaur
  • Hildegard T. Greinix
  • Elisabeth Koller
  • Otto Krieger
  • Werner Linkesch
  • Hedwig Kasparu
  • Michael Pober
  • Wolfgang Hinterberger
  • Hubert Hausmaninger
  • Max Heistinger
  • Ernst Ulsperger
  • Susanne Karlhuber
  • Wolfgang Schwinger
  • Beate Lindner
Original Article

Abstract

Between 1990 and 2001, 68 patients with advanced Hodgkin’s disease (HD) and 86 patients classified as low-/intermediate-grade B non-Hodgkin’s lymphoma (NHL) were reported to the Austrian Stem Cell Transplantation Registry (ASCTR). Following autologous stem cell transplantation (SCT) for HD, overall survival was 56% [95% confidence interval (CI): 40–72%] with a disease-/progression-free survival of 49%, reaching a plateau at 5 years. Using multivariate Cox regression analysis BEAM conditioning (carmustine, cytarabine, etoposide and melphalan) was predictive for favourable outcome, better disease-/progression-free survival and a significantly lower risk for relapse. The cumulative incidence of relapse was 30%, even for patients in complete remission at time of SCT. The cumulative risk for developing a secondary malignancy increased continuously over time, achieving 20% at 7 years and 46% at 10 years with previous radiotherapy as the only risk factor in the multivariate analysis. Overall survival for NHL patients was 45% (95% CI: 26–64%) with a disease-/progression-free survival of 26% at 7 years. In the multivariate Cox regression analysis stage of disease at time of SCT was the most powerful parameter for overall survival, disease-/progression-free survival and relapse. Mantle cell lymphoma, greater than or equal to three lines of previous therapy, and a conditioning regimen other than BEAM were also predictive for death. The main reason for treatment failure was relapse (cumulative incidence 54–75%). Because of the high risk of relapse/progression in both disease categories and the additional high rate of second malignancies in HD patients, allogeneic stem cells should be considered a valuable alternative for selected patients. The efficacy of allotransplantation following reduced-intensity conditioning should be tested in randomised trials.

Keywords

Autologous Transplantation Non-Hodgkin’s lymphoma Hodgkin’s disease Long-term results 

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • David Nachbaur
    • 1
    • 14
  • Hildegard T. Greinix
    • 2
  • Elisabeth Koller
    • 3
  • Otto Krieger
    • 4
  • Werner Linkesch
    • 5
  • Hedwig Kasparu
    • 4
  • Michael Pober
    • 6
  • Wolfgang Hinterberger
    • 7
  • Hubert Hausmaninger
    • 8
  • Max Heistinger
    • 9
  • Ernst Ulsperger
    • 10
  • Susanne Karlhuber
    • 11
  • Wolfgang Schwinger
    • 12
  • Beate Lindner
    • 13
  1. 1.Clinical Division of Hematology and OncologyInnsbruck Medical UniversityInnsbruckAustria
  2. 2.Bone Marrow Transplantation Unit, Department of Medicine IVienna Medical UniversityViennaAustria
  3. 3.Third Medical Department for Hematology and OncologyHanusch HospitalViennaAustria
  4. 4.Department of Internal MedicineElisabethinen HospitalLinzAustria
  5. 5.Division of Hematology, Department of Internal MedicineUniversity of GrazGrazAustria
  6. 6.Department of Internal Medicine IWilhelminen HospitalViennaAustria
  7. 7.Second Department of Internal MedicineDanube HospitalViennaAustria
  8. 8.Department of Internal Medicine IIISt. Johann’s HospitalSalzburgAustria
  9. 9.Department of Internal Medicine IGeneral HospitalKlagenfurtAustria
  10. 10.Department of Internal Medicine V/OncologyLainz HospitalViennaAustria
  11. 11.St. Anna Children’s HospitalViennaAustria
  12. 12.Division of Pediatric Hematology/Oncology, Department of PediatricsGraz Medical UniversityGrazAustria
  13. 13.Austrian Stem Cell Transplantation Registry (ASCTR)InnsbruckAustria
  14. 14.Clinical Division of Hematology and Oncology, Department of Internal MedicineInnsbruck Medical UniversityInnsbruckAustria

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