Maisonneuve-Rosemont Hospital Université de Montréal

Hodgkin’s lymphoma

Prognostic factors

Number of risk factor % FFP at 5 year
0 84
1 77
2 67
3 60
4 51
≥ 5 42

Autologous SCT indications

  1. 1st complete remission
    There is no indication for first line autologous SCT.
  2. 1st partial remission
    Autologous SCT if histological evidence of persistent disease (Positive PET scan is insufficient).
  3. Primary refractory disease
    Autologous SCT after a second line salvage chemotherapy trying to achieve a PR.
  4. Relapse
    Autologous SCT after second line salvage chemotherapy and achieving at least a PR.
  5. Patient refractory to second line salvage chemotherapy
    • Candidate to autologous SCT if in a good PS (ECOG 0-1) and appropriate liver, renal, cardiac and pulmonary function tests.
    • In patient younger then 55 year with a HLA identical sibling donor, allogeneic non myeloablative SCT to consider post autologous transplant if in a good PS with no significant co-morbidity.

Age for autologous transplant

Allogeneic SCT recommendations

  1. Indications
    • Insufficient autologous stem cell collection
    • Relapse post autologous SCT if:
      1. Disease in CR or uCR (unconfirmed CR = residual mass ≥ 1.5 with no sign of active disease scar tissue; (negative PET scan)
      2. PR post salvage chemo with a CR ≥ 12 months post autologous SCT
      3. ECOG 0-1 with appropriate renal, liver, cardiac, and pulmonary function test
      4. even with up-front marrow infiltration by the disease, autologous SCT remains the first line transplant option.
    • Patient refractory to salvage chemotherapy prior the autologous SCT is eligible for NMA allogeneic SCT as a consolidation therapy post auto if younger then 55 years with a compatible sibling donor, good PS and appropriate renal, liver, cardiac and pulmonary function tests.