TY - JOUR
T1 - Comparison of Outcomes of HLA-Matched Related, Unrelated, or HLA-Haploidentical Related Hematopoietic Cell Transplantation following Nonmyeloablative Conditioning for Relapsed or Refractory Hodgkin Lymphoma
AU - Burroughs, Lauri M.
AU - O'Donnell, Paul V.
AU - Sandmaier, Brenda M.
AU - Storer, Barry E.
AU - Luznik, Leo
AU - Symons, Heather J.
AU - Jones, Richard J.
AU - Ambinder, Richard F.
AU - Maris, Michael B.
AU - Blume, Karl G.
AU - Niederwieser, Dietger W.
AU - Bruno, Benedetto
AU - Maziarz, Richard T.
AU - Pulsipher, Michael A.
AU - Petersen, Finn B.
AU - Storb, Rainer
AU - Fuchs, Ephraim J.
AU - Maloney, David G.
N1 - Funding Information:
The authors thank Drs. Peter McSweeney, Rocky Mountain Blood & Marrow Transplantation; Thomas Chauncey, Seattle Veterans Administration Medical Center; Edward Agura, Baylor University; and James Wade, Medical College of Wisconsin for their input and contribution of patients to this study. In addition, we thank Dr. Mohamad Sorror, FHCRC for the HCT-CI scores and the clinical/research staff. This work was supported in part by grants CA78902, CA15704, CA18029, CA15396, HL088021, K12 CA076930, and K23 HL085288 from the National Institutes of Health, Bethesda, MD, and a Clinical Research Scholar Award to E.J.F. from the Leukemia-Lymphoma Society of America. Preliminary results have been reported previously as abstracts at ASBMT and ASH meetings in 2004, 2006, and 2007.
PY - 2008/11
Y1 - 2008/11
N2 - We compared the outcome of nonmyeloablative allogeneic hematopoietic cell transplantation (HCT) for patients with relapsed or refractory Hodgkin lymphoma (HL) based on donor cell source. Ninety patients with HL were treated with nonmyeloablative conditioning followed by HCT from HLA-matched related, n = 38, unrelated, n = 24, or HLA-haploidentical related, n = 28 donors. Patients were heavily pretreated with a median of 5 regimens and most patients had failed autologous HCT (92%) and local radiation therapy (83%). With a median follow-up of 25 months, 2-year overall survivals, progression-free survivals (OS)/(PFS), and incidences of relapsed/progressive disease were 53%, 23%, and 56% (HLA-matched related), 58%, 29%, and 63% (unrelated), and 58%, 51%, and 40% (HLA-haploidentical related), respectively. Nonrelapse mortality (NRM) was significantly lower for HLA-haploidentical related (P = .02) recipients compared to HLA-matched related recipients. There were also significantly decreased risks of relapse for HLA-haploidentical related recipients compared to HLA-matched related (P = .01) and unrelated (P = .03) recipients. The incidences of acute grades III-IV and extensive chronic graft-versus-host disease (aGVHD, cGVHD) were 16%/50% (HLA-matched related), 8%/63% (unrelated), and 11%/35% (HLA-haploidentical related). These data suggested that salvage allogeneic HCT using nonmyeloablative conditioning provided antitumor activity in patients with advanced HL; however, disease relapse/progression continued to be major problems. Importantly, alternative donor stem cell sources are a viable option.
AB - We compared the outcome of nonmyeloablative allogeneic hematopoietic cell transplantation (HCT) for patients with relapsed or refractory Hodgkin lymphoma (HL) based on donor cell source. Ninety patients with HL were treated with nonmyeloablative conditioning followed by HCT from HLA-matched related, n = 38, unrelated, n = 24, or HLA-haploidentical related, n = 28 donors. Patients were heavily pretreated with a median of 5 regimens and most patients had failed autologous HCT (92%) and local radiation therapy (83%). With a median follow-up of 25 months, 2-year overall survivals, progression-free survivals (OS)/(PFS), and incidences of relapsed/progressive disease were 53%, 23%, and 56% (HLA-matched related), 58%, 29%, and 63% (unrelated), and 58%, 51%, and 40% (HLA-haploidentical related), respectively. Nonrelapse mortality (NRM) was significantly lower for HLA-haploidentical related (P = .02) recipients compared to HLA-matched related recipients. There were also significantly decreased risks of relapse for HLA-haploidentical related recipients compared to HLA-matched related (P = .01) and unrelated (P = .03) recipients. The incidences of acute grades III-IV and extensive chronic graft-versus-host disease (aGVHD, cGVHD) were 16%/50% (HLA-matched related), 8%/63% (unrelated), and 11%/35% (HLA-haploidentical related). These data suggested that salvage allogeneic HCT using nonmyeloablative conditioning provided antitumor activity in patients with advanced HL; however, disease relapse/progression continued to be major problems. Importantly, alternative donor stem cell sources are a viable option.
KW - Hematopoietic cell transplantation
KW - Hodgkin lymphoma
KW - Nonmyeloablative
UR - http://www.scopus.com/inward/record.url?scp=53749100859&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=53749100859&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2008.08.014
DO - 10.1016/j.bbmt.2008.08.014
M3 - Article
C2 - 18940683
AN - SCOPUS:53749100859
SN - 1083-8791
VL - 14
SP - 1279
EP - 1287
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 11
ER -