The optimal time for autologous hematopoietic progenitor cell transplantation during treatment of Hodgkin's lymphoma. Foreign recommendations and russian experience

Autologous hematopoietic stem cell transplantation (HSCT) is the standard treatment for patients with relapsed and primary refractory
Hodgkin's lymphoma (HL). According to current recommendations HSCT must be performed in first relapse or after registration of primary resistance disease. However, the HSCT in optimal time for all patients with HL who need it is impossible, due to insufficient capacity of national transplant centers. Analysis of the HSCT results from 369 HL patients treated in Russia and other CIS countries clinics showed that intensive long-term standard chemotherapy prior to transplantation is a poor prognostic factor regarding to mobilization efficacy, hematopoiesis recovery and late HSCT results. In this regard, to achieve best results HSCT must be performed no later than the second relapse or immediately after registration
of primary resistance disease. Treatment results in patients received a lot of chemotherapy before transplantation is worse. But they still
have a chance for a cure and should be considered as potential candidates to HSCT if obtained sufficient graft quality and hematopoietic response to induction chemotherapy is achieved.

1. Franklin J., Diehl V. Current clinical trials for the treatment of advanced-stage Hodgkin's disease: BEACOPP. Ann Oncol 2002;13(Suppl. 1):98–101.

2. American Cancer Society.: Cancer Facts and Figures 2013. Atlanta, Ga: American Cancer Society, 2013. Доступно онлайн: http://www.cancer.org / acs /groups / content / @epidemiologysurveilance /documents / document / acspc-036845. pdf.

3. Linch D. C., Winfield D., Goldstone A. H. et al. Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: Results of a BNLI randomised trial. Lancet 1993;341:1051–4.

4. Schmitz N., Pfistner B., Sextro M. et al. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin's disease: A randomised trial. Lancet 2002;359:2065–71.

5. Sweetenham J. W., Carella A. M., Taghipour G. High-dose therapy and autologous stem cell transplantation for adult patients with Hodgkin's disease who fail to enter remission after induction chemotherapy: results in 175 patients reported to the EBMT. J Clin Oncol 1999;17:3101.

6. Lazarus H., Rowlings P., Zhang M. et al. Autotransplants for Hodgkin's disease in patients never achieving remission: a report from the Autologous Blood and Marrow Transplant Registry. J Clin Oncol 1999;17:534.

7. Reece D., Barnett M., Shepherd J. et al. High-dose cyclophosphamide, carmustine (BCNU), and etoposide (VP16-213) with or without cisplatin (CBV + / – P) and autologous transplantation for patients with Hodgkin's disease who fail to enter a complete remission after combination chemotherapy. Blood 1995;86:451.

8. Longo D., Duffey P., Young R. et al. Conventional-dose salvage combination chemotherapy in patients relapsing with Hodgkin's disease after combination chemotherapy: the low probability for cure. J Clin Oncol 1992;10:210.

9. Bonfante V., Santoro A., Viviani S. et al. Outcome of patients with Hodgkin's disease failing after primary MOPP-ABVD. J Clin Oncol 1997;15:528.

10. Hoppe R. T., Advani R. H., Ai W. Z. et al. Hodgkin lymphoma, version 2.2012 featured updates to the NCCN guidelines. J Natl Compr Canc Netw 2012;10(5):589–97.

11. Eichenauer D. A., Engert A., Dreyling M.; ESMO Guidelines Working Group. Hodgkin's lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2011;22 Suppl 6: vi55–8.

12. Collins G. P., Parker A. N., Pocock C. et al. Guideline on the management of primary resistant and relapsed classical Hodgkin lymphoma. Br J Haematol 2014;164(1):39–52.

13. Kuruvilla J., Keating A., Crump M. How I treat relapsed and refractory Hodgkin lymphoma. Blood 2011;117(16):4208–17.

14. Passweg J. R., Baldomero H., Bregni M. et al. Hematopoietic SCT in Europe: data and trends in 2011. Bone Marrow Transplant 2013;48:1161–7.

15. Статистика злокачественных новообразований в России и странах СНГ в 2007 г. (Под ред. акад. М. И. Давыдова и д.б.н. Е. М. Аксель). Вестн РОНЦ им. Н. Н. Блохина РАМН 2011;22(3). Приложение 1.

16. Филатова Л. В., Тарасенкова А. А., Гершанович М. Л., Семиглазова Т. Ю. Первично-рефрактерные формы лимфомы Ходжкина. Вопр онкол 2012;58(5):627–38.

17. Богатырева Т., Павлов В., Шкляев С. Рецидивы лимфомы Ходжкина: возможности продления жизни без высокодозной химиотерапии. Врач 2012;11:5–8.