Haploidentical transplantation with post-infusion cyclophosphamide in advanced Hodgkin lymphoma

Abstract

We investigated the use of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in the treatment of advanced Hodgkin lymphoma (HL). Sixty-two consecutive HL patients underwent haplo-HSCT. Unmanipulated stem cells and post-transplant cyclophosphamide were given to all patients as GVHD prophylaxis. At 100 days, the cumulative incidence of grades 2-3 and grades 3-4 acute GVHD was 23% and 4%, respectively. The chronic GVHD (cGVHD) cumulative incidence was 16%, with one patient experiencing severe cGVHD. The 3-year OS, PFS, relapse rates and 1-year non-relapse mortality (NRM) were 63%, 59%, 21% and 20%, respectively. Uncontrolled disease status and high hematopoietic cell transplantation comorbidity index (HCT-CI) were associated with lower OS, whereas PBSC was an independent protective factor. Uncontrolled disease and HCT-CI >2 was predictive for NRM. Finally, disease status other than CR was predictive of relapse. In conclusion, haplo-HSCT is a valid treatment in advanced HL, offering excellent rates of survival and acceptable toxicities.

Bone marrow versus mobilized peripheral blood stem cells in haploidentical transplants using posttransplantation cyclophosphamide

“…Interestingly, an advantage in survival and progression-free survival of PBSC over BM has been recently reported in 62 patients receiving a haploidentical transplant for advanced Hodgkin disease. 26 The biology of this disease and its sensitivity to the immunological effect mediated by the haploidentical cells, may in part explain this finding. Bashey et al 13 reported comparable OS and mortality between BM and PBSC recipients in a large series of patients with lymphoid and myeloid malignancies.…”

Viral‐specific T‐cell response in hemorrhagic cystitis after haploidentical donor stem cell transplantation

“…Haplo‐identical HSCT with T‐cell replete grafts and post‐transplant cyclophosphamide‐based GvHD prophylaxis has contributed to favorable outcomes; however, this regimen has been associated with severe HC in the early post‐transplant period, especially in patients with delayed immune reconstitution. We demonstrated that patients having virus‐associated HC in the early post‐transplant phase can develop virus‐specific T cells, and this was associated with viral clearance.…”

Tandem autologous-haploidentical transplantation is a feasible and effective program for refractory Hodgkin lymphoma

“…Every patient provided informed consent. Nineteen patients were included in previous manuscripts [8][9][10]. Inclusion criteria were: lack of HLA-matched related or unrelated donor; primary refractory or relapsed HL refractory to conventional second-line salvage chemotherapy.…”