Outcome of Autologous Stem Cell Transplant in Relapsed/Refractory Hodgkin Lymphoma - A Single Center Study

In relapsed/refractory (R/R) classic Hodgkin lymphoma (cHL), the preferred treatment is autologous stem cell transplantation (ASCT) after receiving high-dose chemotherapy (HDC). Here, we describe and discuss the single-center experience, including outcomes and associated factors.

To provide insight into our experience, our single-center retrospective cohort study included 33 patients (aged 18 years or older at the time of diagnosis) who received HDC/ASCT at Aga Khan University Hospital, Karachi, Pakistan, from January 2013 to December 2023.

Fourteen (42.4%) patients experienced post-transplant relapse, while 10 (30.3%) patients died. The transplant-related mortality (TRM) was seen in 2 (6.1%) patients. Median overall survival (OS) was 65 months, while the median progression-free survival (PFS) was 31 months. The 2-year PFS and OS were 62.1% (95% CI: 45.8-84.1%) and 77.9% (95% CI: 64.6-93.8%), respectively. On univariate analysis, factors associated with lower survival rates included a relapse within one year of initial chemotherapy and the failure to achieve complete remission (CR), both before and after transplantation. Multivariate analysis was not performed due to the small sample size and limited number of events.

This study emphasizes that disease status before and after transplant affects outcomes, showing that achieving CR before ASCT yields better outcomes than achieving PR.