AbstractBackgroundAutologous stem cell transplantation (ASCT) is the standard treatment strategy for refractory or relapsed classical Hodgkin lymphoma (R/R cHL). However, a single transplantation is insufficient to cure the disease because of unfavorable risk factors. Herein, we evaluated the outcomes of single or tandem ASCT in patients with R/R cHL, especially in high‐risk patients.MethodsWe retrospectively analyzed R/R cHL patients who underwent single or tandem ASCT between April 2000 and June 2021 at the Beijing Cancer Hospital and Peking University International Hospital.ResultsA total of 134 patients were enrolled. Patients were allocated to a favorable‐risk group (group A,n= 33), an unfavorable‐risk group (group B,n= 81) that underwent single ASCT, and an unfavorable‐risk group that underwent tandem ASCT (group C,n= 20). The median follow‐up time was 99 months (range, 91–107 months), and no treatment‐related deaths occurred after single or tandem ASCT. However, 27 patients (2 in group C) died during the follow‐up period. The groups A, B, and C had 5‐year progression‐free survival (PFS) rates of 77.05%, 45%, and 74.67%, respectively (p= 0.0014), and 5‐year overall survival (OS) rates of 89.85%, 76.06%, and 95%, respectively (p= 0.18). Neither the median PFS rates of groups A and C nor the OS rates of all groups were reached.ConclusionsOur study discusses the advantages of tandem transplantation for high‐risk patients with R/R cHL.