F‐18 FDG ‐ PET predicts outcomes for patients receiving total lymphoid irradiation and autologous blood stem‐cell transplantation for relapsed and refractory H odgkin lymphoma

Total lymphoid irradiation ( TLI ) followed by high‐dose chemotherapy and autologous haematopoietic stem cell transplant ( aHSCT ) is an effective strategy for patients with relapsed/refractory classical Hodgkin lymphoma ( HL ). We report outcomes for patients with relapsed/refractory HL who received TLI followed by high‐dose chemotherapy and aHSCT . Pre‐transplant fludeoxyglucose positron emission tomography ( FDG ‐ PET ) studies were scored on the 5‐point D eauville scale. Of 51 patients treated with TLI and aHSCT , 59% had primary refractory disease and 63% had active disease at aHSCT . The 10‐year progression‐free survival ( PFS ) and overall survival ( OS ) for all patients was 56% and 54%, respectively. Patients with complete response ( CR ) by PET prior to aHSCT had a 5‐year PFS and OS of 85% and 100% compared to 52% and 48% for those without CR ( P = 0·09 and P = 0·007, respectively). TLI and aHSCT yields excellent disease control and long‐term survival rates for patients with relapsed/refractory HL , including those with high‐risk disease features. Achievement of CR with salvage therapy is a powerful predictor of outcome.