Reduction in incidence of early fatal complications of high-dose chemotherapy with autologous hematopoietic stem cell transplantation in Hodgkin lymphoma patients

Traditionally, the concern of fatal complication is a major obstacle to transfer patients with unfavorable course of Hodgkin’s lymphoma to
national transplantation centers. Early mortality after high-dose chemotherapy with autologous hematopoietic stem cell transplantation
(HSCT) in the Russia, Ukraine and Belarus was assessed in this retrospective multicenter study.

Patients and methods. The study included 372 patients with unfavorable course of Hodgkin’s lymphoma received HSCT between 01.1990
and 06.2013: 35.5 % patients with primary resistance, 30.6 % with early relapse, 33.1 % with late relapse and 0.8 % during consolidation of
first complete remission.

Results. During first 100 days after HSCT died 14 (3.8 %) patients, during first year – 31 (8.4 %) patients. During the study period a significant decrease in the 100-day and 1-year mortality rate was observed (p < 0.0001 for both). Among patients received HSCT in 1990–
1995, 1996–2000, 2001–2005 and 2006–2013 the 100-day mortality was 19.4 %, 6.3 %, 1.1 % and 0.6 %, respectively. 1-year mortality for the same intervals was 32.3 %, 14.7 %, 4.5 % and 1.9 %, respectively.

Conclusions. Currently HSCT in patients with unfavorable course of Hodgkin's lymphoma in national transplant centers, accompanied by an extremely low risk of fatal toxicity.

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