Survival Analysis For Lymphoma Patients After Autologous Stem Cell Transplantation

Background and objectives: Hematopoietic stem cell transplantation(HSCT) is considered to be a cure for lymphoma and may be the only creatment for multiple malignant hematopoietic diseases, such as leukemia and lymphoma. Clinical analysis confirmed that HSCT can significantly decrease the rate of disease relapse and improve the survival rate compared with conventional chemoimmunotherapy. Recent studies show that there are many factors can affect the prognosis including age, pathological classification, clinical characteristics, hemogram, myelogram, molecular biology characterization, remission status before transplantation, conditioning regimen and transplanted stem cell numbers. This article aimed at investigating the factors that affect lymphoma patients’ prognosis with autologous HSCT(Auto HSCT).Material and methods: We retrospectively analyzed eighty patients diagnosed with lymphoma and treated with Auto HSCT during 2006 to 2012 in our hospital. There are 11( 13.7%) cases of Hodgkin ’s lymphoma and 69(86.3%) of non-Hodgkin’s lymphoma. Basic clinical data, status before transplantation and prognosis after transplantation were collected. Statistical analysis was performed using the SPSS version 19.0. Kaplan–Meier method was used to analyze survival result. Univariate analysis and multivariate analysis were performed with Cox proportional hazards model.Results: After a median follow-up of 37.9 months by telephone, the median survival time was 40.9 months. Twenty patients(25%) died at the time of final analysis. 2 had no relapse and 18 presented disease progression. Of 2 patients died without relapse, one died of multiple organ dysfunction syndrome(MODS) due to severe pneumonia, and the other patient died of acute liver failure due to other causes unrelated to lymphoma progression. The 3-year cumulative probability of OS and PFS was 75%. Results from univariate analysis confirmed age, serum LDH, IPI score, ECOG, bone marrow involvement, and time to neutrophil recovery were associated with OS. Of note, multivariate analysis showed only IPI score and time to neutrophil recovery were independent factors related to OS.Conclusions: Auto HSCT is a favorable treatment for lymphoma patients especially for relapsed and refractory lymphoma. These patients will obtain a long-term survival. IPI and neutrophil recovery are predictors for lymphoma patients after Auto HSCT.