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To review the outcomes of refractory and relapsed Hodgkin’s Lymphoma in pediatric patients treated with high dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT) at a single center.
Materials and methods:
All patients, up to the age of 18 years, with refractory or relapsed Hodgkin’s Lymphoma who had complete or good-partial response to salvage chemotherapy were included in the study. All received HDC and ASCT during October 2010 to June 2014. Medical records of these patients were reviewed. The following variables were collected in addition to demographics and stage of disease at the time of relapse.
- Time to engraftment from the day of stem cells re-infusion
- Radiological response assessed by PET-CT at day-60 after stem cell re-infusion and
- Disease free interval till the last follow-up
Results:
Nineteen patients were studied, 15 were male. Median age at relapse was 13 years (range 4-18 years). At the time of relapse, 10 patients had stage IV disease, 6 had stage III and two of stage II and one of Stage I. Median time to engraftment was 13 days (range 10-21 days). Complete Metabolic remission was demonstrated in all 19 cases on FDG PET/CT scan on day-60. Two patients had significant morphological residual disease requiring involved field radiation therapy. All but one patient remained disease free for the duration of follow-up (median 16 months, range 3- >44 months). Disease free survival (DFS) was 92 % during this follow-up period. One patient with had disease progression at 7 months post ASCT.
Conclusion:
HDC( BEAM) followed by ASCT, appears an effective treatment strategy for relapsed or refractory pediatric Hodgkin’s Lymphoma who had complete or good-partial response to salvage chemotherapy, in our single center experience during our short term follow-up. Long term follow-up is suggested to evaluate disease free and overall survival benefits