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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)

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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.

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Authors and Affiliations

  1. Clinical Division of Hematology and Oncology, Innsbruck Medical University, Innsbruck, Austria

    David Nachbaur

  2. Bone Marrow Transplantation Unit, Department of Medicine I, Vienna Medical University, Vienna, Austria

    Hildegard T. Greinix

  3. Third Medical Department for Hematology and Oncology, Hanusch Hospital, Vienna, Austria

    Elisabeth Koller

  4. Department of Internal Medicine, Elisabethinen Hospital, Linz, Austria

    Otto Krieger & Hedwig Kasparu

  5. Division of Hematology, Department of Internal Medicine, University of Graz, Graz, Austria

    Werner Linkesch

  6. Department of Internal Medicine I, Wilhelminen Hospital, Vienna, Austria

    Michael Pober

  7. Second Department of Internal Medicine, Danube Hospital, Vienna, Austria

    Wolfgang Hinterberger

  8. Department of Internal Medicine III, St. Johann’s Hospital, Salzburg, Austria

    Hubert Hausmaninger

  9. Department of Internal Medicine I, General Hospital, Klagenfurt, Austria

    Max Heistinger

  10. Department of Internal Medicine V/Oncology, Lainz Hospital, Vienna, Austria

    Ernst Ulsperger

  11. St. Anna Children’s Hospital, Vienna, Austria

    Susanne Karlhuber

  12. Division of Pediatric Hematology/Oncology, Department of Pediatrics, Graz Medical University, Graz, Austria

    Wolfgang Schwinger

  13. Austrian Stem Cell Transplantation Registry (ASCTR), Innsbruck, Austria

    Beate Lindner

  14. Clinical Division of Hematology and Oncology, Department of Internal Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    David Nachbaur

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Nachbaur, D., Greinix, H.T., Koller, E. et al. 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). Ann Hematol 84, 462–473 (2005). https://doi.org/10.1007/s00277-004-1003-3

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