March 8, 2009

Autologous Stem Cell Transplantation Effective for Relapsed Hodgkin’s Lymphoma


Autologous Stem Cell Transplantation Effective for Relapsed Hodgkin’s Lymphoma

Autologous stem cell transplantation is effective for patients with Hodgkin’s lymphoma that has progressed following prior therapies. These results were recently published in the Annals of Oncology.

Hodgkin’s lymphoma is a cancer of the lymph system. It is diagnosed by the presence of a cell that is characteristic of the disease, the Reed-Sternberg cell. Hodgkin’s lymphoma typically begins in the lymph nodes in one region of the body and then spreads throughout the lymph system. It may spread outside the lymph system to other organs, such as the lungs, liver, bone, and bone marrow.

Patients with Hodgkin’s whose cancer returns following prior therapy (recurrent) or whose disease does not respond to standard therapies (refractory) may undergo treatment with an autologous stem cell transplant.

Stem cell transplantation is a procedure that includes the use of high doses of therapy to kill more cancer cells than standard doses. However, the high doses also destroy normal cells, such as blood cells. The destruction of blood cells-particularly immune cells, red blood cells, and platelets-can lead to life-threatening side effects.

To compensate for dangerously low levels of blood cells following high-dose therapy, patients receive an infusion of hematopoietic stem cells (immature blood cells). These stem cells mature into the three types of blood cells. In an autologous stem cell transplant, the patient’s own stem cells are collected prior to high-dose therapy and then re-infused following therapy.

Researchers from the Royal Marsden Hospital recently reported long-term data including 195 patients with recurrent Hodgkin’s lymphoma who received an autologous stem cell transplant between 1985 and 2005.

  • 61% of patients achieved a complete disappearance of cancer.
  • Median survival was nine years.
  • Median progression-free survival was three years.
  • Five- and 10-year overall survivals were 55% and 49%, respectively.
  • 10% of patients developed a second cancer, the most of which were acute myeloid leukemia or myelodysplastic syndromes.
  • Mortality caused by treatment occurred in 6% of patients.

The researchers concluded that an autologous stem cell transplant provides an effective long-term therapeutic option for patients with Hodgkin’s lymphoma that has stopped responding to prior therapies. Patients with recurrent Hodgkin’s lymphoma may wish to speak with their physician about their individual risks and benefits of an autologous stem cell transplant.

Reference: Sirohi B, Cunningham D, Powles R, et al. Long-term outcome of autologous stem-cell transplantation in relapsed or refractory Hodgkin’s lymphoma. Annals of Oncology. 2008;19:1312-1319.

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