Analiza uspješnosti alogenične transplantacije pacijenata s Hodgkinovim limfomom u KBC Zagreb u razdoblju od 2014. do 2021. godine

master's thesis

• Title (english): Efficacy analysis of allogeneic stem cell transplantation in patients with Hodgkin lymphoma in UHC Zagreb in the period from 2014 until 2021
• Author: Ana Andrić
• Mentor: Nadira Duraković (mentor)
• Committee member: Radovan Vrhovac (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Nadira Duraković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Hodgkinov limfom (HL) maligna je bolest B limfocita germinativnog centra. U liječenju HL-a prvenstveno se koristi kemoterapija s ili bez radioterapije. Ipak, oko 10% slučajeva refraktorno je na prvu liniju liječenja, te oko 30% njih uđe u relaps. Nakon visokih doza spasonosne kemoterapije praćene autolognom transplantacijom koštane srži (AHSCT), u trećoj liniji liječenja često koristimo alogeničnu transplantaciju koštane srži (allo-HSCT).
Cilj rada bio je istražiti ukupno preživljenje (OS) i preživljenje bez progresije bolesti (PFS) pacijenata s Hodgkinovim limfomom kojima je učinjena alogenična transplantacija koštane srži u KBC-u Zagreb u razdoblju od 2014. do 2021. godine.
U istraživanje je uključeno 27 pacijenata oboljelih od Hodgkinova limfoma.
Ukupno preživljenje (OS) 2 godine nakon transplantacije iznosi 80,2%, a preživljenje bez progresije (PFS) u istom trenutku iznosi 66,8%.
Razlika u preživljenju s obzirom na stanje bolesti prije transplantacije (kompletna/parcijalna remisija) analizirana je koristeći log-rank test. Nije pronađena statistički značajna razlika u OS-u (p=0.21) i u PFS-u (p=0,158) između navedenih skupina.
Trinaest (48,1%) pacijenata razvilo je aGvHD, a 3 (11,1%) cGvHD. Relaps bolesti imalo je 8 (29,6%) pacijenata s medijanom pojavljivanja relapsa 5 mjeseci od transplantacije. Ukupno je umrlo 5 (18,5%) osoba, a njih 2 (7,4%) umrlo je od infekcije, a ne od relapsa bolesti (NRM).
Alogenična transplantacija hematopoetskih matičnih stanica postiže vrlo dobre rezultate ukupnog preživljenja i preživljenja bez progresije. Primjenom novih lijekova i sve bolje potporne terapije može se očekivati sve uspješnije liječenje ove skupine pacijenata.

Abstract (english)

Hodgkin lymphoma (HL) is a haematological malignancy arising from germinal centre B-cells. Chemotherapy with or without radiation is the mainstay of first-line therapy. However, approximately 10% of cases have a refractory disease, and 30% of them relapse after initial treatment. If high doses of salvage chemotherapy followed by autologous hematopoietic stem cell transplantation prove to be unsuccessful, most often allogeneic stem cell transplantation (allo-HSCT) is performed as the third-line treatment.
This study aimed to evaluate the overall survival (OS) and progression-free survival (PFS) in patients with HL who underwent allo-HSCT in UHC Zagreb in the period from 2014 until 2021.
The study included 27 patients with Hodgkin lymphoma.
The 2-year overall survival (OS) and progression-free survival (PFS) were 80,2% and 66,8%, respectively.
The difference in survival according to disease status at the time of transplantation was estimated using the log-rank test. The analysis showed no significant difference in OS (p=0.21) or PFS (p=0,158) between the groups.
13 (48,1%) patients developed acute GvHD and 3 (11,1%) of them developed chronic GvHD. During the follow-up, 8 (29,6%) of them relapsed, which occurred a median of 5 months after allo-HSCT. 5 (29,6%) patients died and 2 (7,4%) of them have not died from relapse, but from infectious complications (NRM).
Allogeneic stem cell transplantation leads to relatively high overall survival and progression-free survival in these patients. The use of new agents and improved supportive care will potentially bring even better results in the future.

• Keywords: alogenična transplantacija; Hodgkinov limfom; preživljenje
• Keywords (english): allogeneic transplantation; Hodgkin lymphoma; survival
• Language: croatian
• URN:NBN: urn:nbn:hr:105:640355
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-02 10:27:08