Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8430174 | Biology of Blood and Marrow Transplantation | 2018 | 24 Pages |
Abstract
Allogeneic hematopoietic stem cell transplantation (SCT) represents a potential curative strategy for patients with Hodgkin lymphoma (HL) relapsing after autologous SCT (ASCT), but the incidence of disease relapse is still high. We performed a retrospective study on 64 patients with HL relapsing after ASCT to compare outcomes after HLA-identical SCT (HLAid-SCT; nâ=â34) and haploidentical SCT with post-transplantation cyclophosphamide (PT-Cy) (Haplo-SCT; nâ=â30). All patients engrafted, with a significantly shorter median time for neutrophil and platelet engraftment after HLAid compared with Haplo-SCT (14 days versus 19 days and 11 days versus 23 days, respectively; Pâ<â.005). With a median follow-up of 47 months, 3-year overall survival (OS), 3 -year progression-free survival (PFS), and 1-year nonrelapse mortality (NRM) were 53%, 44% and 17%, respectively. Recipients of Haplo-SCT were less likely to experience disease relapse (3-year cumulative incidence of relapse, 13% versus 62%; Pâ=â.0001) and chronic graft- versus-host disease (GVHD; 3% versus 32%; Pâ=â.003), resulting in improved PFS (60% versus 29%; Pâ=â.04) and GVHD-free/relapse-free survival (47% versus 17%; Pâ=â.06). The 3-year OS did not differ between the 2 groups (56% versus 54%; Pânot significant), and NRM was higher after Haplo-SCT, but the difference did not reach statistical significance (26% versus 9%; Pâ=â.09). On multivariate Cox regression analysis, receipt of Haplo-SCT (hazard ratio [HR], .17; Pâ=â.02) and achieving optimal disease control (complete remission before SCT: HR, .6; Pâ<â.0001) were the only independent variables associated with a reduced risk of disease relapse. Haplo-SCT is a valid option for patients with HL relapsing after ASCT, with a reduced incidence of relapse compared with HLAid SCT.
Related Topics
Life Sciences
Biochemistry, Genetics and Molecular Biology
Cancer Research
Authors
Jacopo Mariotti, Raynier Devillier, Stefania Bramanti, Barbara Sarina, Sabine Furst, Angela Granata, Catherine Faucher, Samia Harbi, Lucio Morabito, Christian Chabannon, Carmelo Carlo-Stella, Reda Bouabdallah, Armando Santoro, Didier Blaise,