Disease Status Is the Major Prognosis Factor for Allogenic Transplantation Outcome for Hodgkin Lymphoma: a Retrospective Study From the French Society of Bone Marrow Graft Transplantation and Cellular Therapy (SFGM-TC)
Bibliographic record
Abstract
Abstract Abstract 2359 Background: The role of allogenic stem cell transplantation (SCT) for the treatment of relapsed/refractory Hodgkin Lymphoma (HL) remains controversial. Patients and Methods: we retrospectively analyzed 227 patients who underwent alloSCT between April 1998 and December 2008 for relapsed HL and whose data were reported in the French Society of Marrow Transplantation and Cellular Therapy registry. Thirty-six patients underwent alloSCT with Myeloabaltive Conditioning (MAC) and 191 with Reduced Intensity Conditioning (RIC). Median age was 31 years (13-63 years). Median number of previous therapy regimens was 4. Eighty-nine percent of patients had received a previous Autologous Stem Cell Transplantation (ASCT). Results: Median follow up was 36 months (2-103 months). The 1-year cumulative incidence of non-relapse mortality (NRM) was 17%. Estimated 3 years Overall Survival (OS), Progression free Survival (PFS) and cumulative incidence of relapse (CIR) were 55%, 36%, 47%, respectively for the entire cohort. In multivariate analysis, there was no difference in outcome between patients in CR and PR at time of transplantation for OS (67% vs 68% at 3 years) and PFS (50% vs 40% at 3 years, p=ns). However, patients with chemoresistant disease (stable or progressive) at time of transplantation had a significantly shorter PFS (13% at 3 years p<0.0001) and OS (30% at 3 years p<0.0001) than patients with chemosensitive disease (CR and PR). Moreover, patients with chemoresistant disease have a higher CIR and NRM compared to patients with chemosensitive disease: 62% versus 40% (p<0.0001) and 28% versus 13% (p=0.015) at 3 years. Interestingly, in multivariate analysis for OS, previous ASCT occurring less than 3 months before allogenic stem cell transplantation was found to be associated with better outcome (HR=0.51 (0.27 to 0.99, 95% CI), p=0.046). Use of cord blood was associated with poor outcome (HR =2.74 (1.12 to 6.71, 95%CI), p=0.027). However, there was no impact of chronic Graft-versus-host disease (cGVHD) on outcome when cGVHD was studied as a time-dependent covariate. Conclusion: This study shows that Allogenic SCT especially following reduced intensity conditioning is a feasible option for relapsed HL. Disease status at transplantation remains the major risk factor for outcome. In addition our data suggest that allogenic SCT should be performed as early as possible after ASCT. Disclosures: No relevant conflicts of interest to declare.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".