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Autologous hematopoietic cell transplantation for the treatment of relapsed/refractory pediatric, adolescent, and young adult Hodgkin lymphoma: a single institutional experience

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Abstract

Pediatric, adolescent, and young adult patients with relapsed or refractory Hodgkin lymphoma receive multimodal therapy, including autologous hematopoietic cell transplantation (AutoHCT). Despite aggressive therapy, historical outcomes for this patient population have been poor. This paper describes a single institutional experience utilizing AutoHCT in 74 patients treated from 1988–2015. Our results demonstrate significantly improved outcomes over time. Compared with patients treated in the earlier era (1988–2001), 5-year overall survival improved from 62.5 ± 9.6% to 91.8 ± 4.4% (p < 0.001) and event free survival improved from 41.7 ± 9.6% to 87.7 ± 5.3% (I < 0.001) for patients treated in a later era (2002–2015). Improvements in survival are multifactorial, including reductions in both relapse and nonrelapse mortality. Further investigation is needed to determine the role of AutoHCT in a modern treatment cohort that includes frequent use of targeted immunotherapies. In addition, as the use and availability of effective novel therapeutics increases for this patient population there may be an opportunity for the reduction of standard cytotoxic therapies, including in AutoHCT preparative regimens, thereby mitigating late effects.

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Fig. 1: Outcomes for entire treatment cohort and by treatment era of pediatric, adolescent and young adult patients with relapsed or refractory Hodgkin lymphoma whom underwent autologous hematopoietic cell transplantation between the years 1988 and 2015 (n = 74).
Fig. 2: Outcomes by disease status, within the late treatment era cohort of pediatric, adolescent and young adult patients with relapsed or refractory Hodgkin lymphoma whom underwent autologous hematopoietic cell transplantation (n = 50).

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Acknowledgements

This work was supported in part by the American Lebanese Syrian Associated Charities (ALSAC).

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Authors and Affiliations

  1. Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Aimee C. Talleur, David R. Shook & Brandon M. Triplett

  2. Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Jamie E. Flerlage & Melissa M. Hudson

  3. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Abigail M. Chilsen

  4. Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Cheng Cheng & Sujuan Huang

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  1. Aimee C. Talleur
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  2. Jamie E. Flerlage
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Correspondence to Aimee C. Talleur.

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Talleur, A.C., Flerlage, J.E., Shook, D.R. et al. Autologous hematopoietic cell transplantation for the treatment of relapsed/refractory pediatric, adolescent, and young adult Hodgkin lymphoma: a single institutional experience. Bone Marrow Transplant 55, 1357–1366 (2020). https://doi.org/10.1038/s41409-020-0879-4

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