Factors Associated with Lymphoma Recurrence Following Autologous Stem Cell Transplantation

Abstract

Introduction: Non-responsive or relapsed lymphoma patients may benefit from salvage chemotherapy or high-dose chemotherapy followed by autologous stem cell transplantation (ASCT), an effective treatment, particularly in non-Hodgkin’s and Hodgkin’s lymphoma. This study aimed to investigate recurrence in these patients and identify associated risk factors.

Methods: A retrospective cohort study analyzed outcomes of lymphoma patients un- dergoing ASCT at Omid Hospital (2016-2020). Comprehensive data on demograph- ics, treatment, underlying disease, recurrence, and pre-transplantation laboratory parameters were collected from hospital records. Follow-up from transplantation to February 2021 allowed for survival and recurrence evaluation using Kaplan-Meier and Cox regression. The study included patients without concurrent plasma cell dis- orders or other hematological malignancies for a focused lymphoma treatment out- come analysis.

Results: 49 lymphoma patients underwent ASCT (21 HL, 42.9%; 28 NHL, 57.1%). Gender distribution was similar (30 males, 61.2%; 19 females, 38.8%; P=0.774). Mean age at transplantation was 38.8 ± 11.15 years (P=0.519 between groups). Recurrence occurred in 14 patients (7 in each group; P=0.523), with a mean recurrence-free sur- vival (RFS) of 25.2 months (95% CI: 21.44-28.96). HL patients had a lower mean RFS and a higher recurrence hazard ratio (HR: 1.25, 95% CI: 0.420-3.76), though not statistically significant (P=0.683). In NHL, older age significantly correlated with recurrence (P=0.030). While male gender and older age were associated with lower survival, only advanced age in NHL significantly predicted decreased survival (HR: 2.16, recalculated per 5-year increment, 95% CI: 1.63-2.45).

Conclusions: Advanced age significantly predicted reduced survival in NHL pa- tients. Pre-transplant laboratory markers did not show a significant association with survival. Given the limited sample size and exploratory nature of this study, the re- sults warrant validation in larger, multicenter cohorts.