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Unrelated donor reduced-intensity allogeneic hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma. Biol Blood Marrow Transplant 2009 Jan;15(1):109-17 PMID: 19135949 PMCID: PMC2929570

Pubmed ID

19135949

DOI

10.1016/j.bbmt.2008.11.011

Abstract

Myeloablative allogeneic hematopoietic cell transplantation (HCT) may cure patients with relapsed or refractory Hodgkin lymphoma (HL), but is associated with a high treatment-related mortality (TRM). Reduced-intensity and nonmyeloablative (RIC/NST) conditioning regimens aim to lower TRM. We analyzed the outcomes of 143 patients undergoing unrelated donor RIC/NST HCT for relapsed and refractory HL between 1999 and 2004 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Patients were heavily pretreated, including autologous HCT in 89%. With a median follow-up of 25 months, the probability of TRM at day 100 and 2 years was 15% (95% confidence interval [CI] 10%-21%) and 33% (95% CI 25%-41%), respectively. The probabilities of progression free survival (PFS) and overall survival (OS) were 30% and 56% at 1 year and 20% and 37% at 2 years. The presence of extranodal disease and the Karnofsky Performance Scale (KPS) <90 were significant risk factors for TRM, PFS, and OS, whereas chemosensitivity at transplantation was not. Dose intensity of the conditioning regimen (RIC versus NST) did not impact outcomes. Unrelated donor HCT with RIC/NST can salvage some patients with relapsed/refractory HL, but relapse remains a common reason for treatment failure. Clinical studies should be aimed at reducing the incidence of acute graft-versus-host disease (GVHD) and relapse.

Author List

Devetten MP, Hari PN, Carreras J, Logan BR, van Besien K, Bredeson CN, Freytes CO, Gale RP, Gibson J, Giralt SA, Goldstein SC, Gupta V, Marks DI, Maziarz RT, Vose JM, Lazarus HM, Anderlini P

Authors

Parameswaran Hari MD Chief, Professor in the Medicine department at Medical College of Wisconsin
Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-58149197557   77 Citations

MESH terms used to index this publication - Major topics in bold

Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Hodgkin Disease
Humans
Recurrence
Retrospective Studies
Risk Factors
Salvage Therapy
Survival Analysis
Tissue Donors
Transplantation Conditioning
Transplantation, Homologous
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5