Prognostic factors affecting long-term outcome after stem cell transplantation in Hodgkin's lymphoma autografted after a first relapse

Purpose: To analyse outcome and prognostic factors for overall survival (OS) and time to treatment failure (TTF) in 357 patients with Hodgkin's lymphoma (HL) undergoing an autologous stem cell transplantation (ASCT) after a first relapse and reported to the The Grupo EspaNol de Linfomas/ Trasplante AutOlogo de MEdula Osea (GEL/TAMO) Cooperative Group. Methods: Two hundred and twenty mates and 137 females with a median age of 29 years were autografted in second remission (n = 18 1), first sensitive relapse (n = 148) and first resistant relapse (n = 28). Results: Five-year actuarial TTF and OS were of 49% 3% and 57% 3%. Advanced stage at diagnosis, complementary radiotherapy before ASCT, a short first complete response (CR) and detectable disease at ASCT adversely influenced TTF. Year of transplant <= 1995, bulky disease at diagnosis, a short first CR, detectable disease at ASCT and >= 1 extranodal areas involved at ASCT were adverse factors for OS. Conclusions: ASCT constitutes a therapeutic option for HL patients after a first relapse. Promising results are observed in patients with low tumour burden at diagnosis, autografted after a long CR and without detectable disease at ASCT. Innovative approaches should be pursued for patients with risk factors at relapse.