Hematopoietic stem cell transplantation for hodgkin lymphoma

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Autologous hematopoietic stem cell transplant (auto-HSCT) remains the cornerstone for relapsed and refractory Hodgkin lymphoma (HL) as well as patients with primary induction failure HL. Chemosensitive disease has better outcomes, and attaining a positron emission tomography (PET)-negative response before autologous transplant portends better overall survival (OS) and progression-free survival (PFS). The goal of salvage chemotherapy is to perform optimal cytoreduction before auto-HSCT with the least amount of toxicity. More intensive conditioning regimens have shown improved PFS and OS in phase II trials; however, randomized trials need to be explored in larger setting. Radiation therapy can improve disease control in the peri-auto-HSCT period for bulky disease and residual PET-positive disease. Maintenance therapy should be studied in clinical trials; however, for high-risk patients, brentuximab maintenance is now the standard. Allogeneic HSCT can provide a durable remission for patients who relapse after autologous HSCT and however can have significant complications associated with graft-versus-host disease and infection associated with immune suppression. Long-term side effects secondary to transplant remain an important issue that require careful follow-up and monitoring.

Original languageEnglish (US)
Title of host publicationHematopoietic Cell Transplantation for Malignant Conditions
PublisherElsevier
Pages231-243
Number of pages13
ISBN (Electronic)9780323568029
ISBN (Print)9780323568036
DOIs
StatePublished - Jan 1 2019

Keywords

  • Allogeneic transplant
  • Autologous transplant
  • Intensive conditioning regimens
  • Maintenance after transplant
  • Salvage chemotherapy

ASJC Scopus subject areas

  • General Medicine

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