Impact of disease status and stem cell source on the results of reduced intensity conditioning transplant for Hodgkin's lymphoma: a retrospective study from the French Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)

Marçais, Ambroise; Porcher, Raphaël; Robin, Marie; Mohty, Mohamad; Michalet, Mauricette; Blaise, Didier; Tabrizi, Reza; Clément, Laurence; Céballos, Patrice; Bilger, Karin; Dhédin, Nathalie; Lapusan, Simona; Bay, Jacques‐Olivier; Pautas, Cécile; Garban, Frédéric; Ifrah, Norbert; Guillerm, Gaëlle; Contentin, Nathalie; Bourhis, Jean‐Henri; Yakoub-Agha, Ibrahim; Bernard, Marc; Cornillon, Jérôme; Milpied, Noël

doi:10.3324/haematol.2012.080895

Cited by 39 publications

(26 citation statements)

References 29 publications

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“…Although the number of patients who received a RIC regimen was small in our study, we also observed an even higher incidence of NRM compared to those who received myeloablative conditioning regimens (57% vs. 44%). This is in contrast to the three studies including HD patients TBI‐based RIC UCBT without ATG where the 2 and 3‐yr NRM incidence account for 13–22%. So far, these studies included a lower proportion of chemo‐resistant patients (8–12%) than in our study (26%).…”

Section: Discussioncontrasting

confidence: 70%

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Umbilical cord blood transplantation in adults with advanced hodgkin's disease: high incidence of post‐transplant lymphoproliferative disease

Piñana¹,

Sanz

Esquirol

et al. 2015

European J of Haematology

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We report the outcome of 30 consecutive patients with Hodgkin disease (HD) who underwent single-unit UCBT. Most (90%) patients had failed previous autologous hematopoietic stem cell transplantation. The conditioning regimens were based on combinations of thiotepa, busulfan, cyclophosphamide or fludarabine, and antithymocyte globulin. The cumulative incidence (CI) of myeloid engraftment was 90% [95% confidence interval (C.I.), 74-98%] with a median of 18 d (range, 10-48). CI of acute graft-versus-host disease (GvHD) grades II-IV was 30% (95% C.I., 17-44%), while the incidence of chronic GVHD was 42% (95% C.I., 23-77%). The non-relapse mortality (NRM) at 100 d and 4 yr was 30% (95% C.I., 13-46%) and 47% (95% C.I., 29-65%), respectively. EBV-related post-transplant lymphoproliferative disease (EBV-PTLD) accounted for more than one-third of transplant-related death, with an estimate incidence of 26% (95% C.I., 9-44). The incidence of relapse at 4 yr was 25% (95% C.I., 9-42%). Four-year event-free survival (EFS) and overall survival (OS) were 28% and 30%, respectively. Despite a high NRM and an unexpected high incidence of EBV-PTLD, UCBT in heavily pretreated HD patients is an option for patients lacking a suitable adult donor, provided the disease is not in refractory relapse.

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Section: Discussioncontrasting

confidence: 70%

“…So far, these studies included a lower proportion of chemo‐resistant patients (8–12%) than in our study (26%). Several studies supported that chemo‐resistant disease at transplant was the most important factor related with superior NRM irrespectively of the conditioning and the source of stem cells used .…”

Section: Discussionmentioning

confidence: 99%

Umbilical cord blood transplantation in adults with advanced hodgkin's disease: high incidence of post‐transplant lymphoproliferative disease

Piñana¹,

Sanz

Esquirol

et al. 2015

European J of Haematology

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“…2A). Recently, many studies have mainly used reducedintensity conditioning for allogeneic HSCT, and most of these patients had previously undergone autologous HSCT [15][16][17]. Sureda et al compared the outcomes of allogeneic HSCT for patients with relapsed and refractory HL with myeloablative conditioning to those with reduced-intensity conditioning [18].…”

Section: Discussionmentioning

confidence: 99%

The role of hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma

et al. 2014

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on behalf of the Adult Lymphoma Working Group of the Japanese Society for Hematopoietic Cell TransplantationThe optimal treatment strategy with the use of hematopoietic stem cell transplantation (HSCT) for relapsed and refractory Hodgkin lymphoma (HL) remains unclear. We performed a retrospective analysis using registry data from the Japanese Society for Hematopoietic Cell Transplantation. Adult patients with HL who underwent a first autologous or a first allogeneic HSCT between 2002 and 2009 were included. Patients who underwent HSCT in first complete remission (CR) were excluded. Autologous and allogeneic HSCT were performed in 298 and 122 patients, respectively. For autologous HSCT, overall survival at 3 years (3yOS) was 70%, and sex, age, disease status, and performance status (PS) at HSCT were prognostic factors. OS was favorable even in patients who underwent autologous HSCT in disease status other than CR. For allogeneic HSCT, 3yOS was 43%, and sex and PS at HSCT were prognostic factors. Disease status at HSCT, previous autologous HSCT, and conditioning intensity did not affect OS. Moreover, graft-versus-host disease did not affect progression-free survival or relapse/progression rate. A first allogeneic HSCT without a previous autologous HSCT was performed in 40 patients. 3yOS was 45%, and was significantly inferior to that in patients who underwent their first autologous HSCT. This result was retained after the correction by the different patient characteristics according to the type of HSCT. In conclusion, autologous HSCT is effective in prolonging survival in patients with relapsed and refractory HL. Allogeneic HSCT might be beneficial even to relapsed HL after autologous HSCT, although establishing the role of allogeneic HSCT remains a challenge.

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“…Marcais et al reported a 39% OS rate and an 18% PFS rate for chemorefractory disease compared to patients in CR, who had a 70%-74% OS rate and a 40%-51% PFS rate at 3 years [26]. In our study, 36 patients were in CR and 25 patients were without remission.…”

Section: Discussionmentioning

confidence: 51%

Prognostic Factors and a New Prognostic Index Model for Children and Adolescents with Hodgkin’s Lymphoma Who Underwent Autologous Hematopoietic Stem Cell Transplantation: A Multicenter Study of the Turkish Pediatric Bone Marrow Transplantation Study

Kesik¹,

Ataş²,

Karakükçü³

et al. 2016

Tjh

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Objective:The prognostic factors and a new childhood prognostic index after autologous hematopoietic stem cell transplantation (AHSCT) in patients with relapsed/refractory Hodgkin’s lymphoma (HL) were evaluated.Materials and Methods:The prognostic factors of 61 patients who underwent AHSCT between January 1990 and December 2014 were evaluated. In addition, the Age-Adjusted International Prognostic Index and the Childhood International Prognostic Index (CIPI) were evaluated for their impact on prognosis.Results:The median age of the 61 patients was 14.8 years (minimum-maximum: 5-20 years) at the time of AHSCT. There were single relapses in 28 patients, ≥2 relapses in eight patients, and refractory disease in 25 patients. The chemosensitivity/chemorefractory ratio was 36/25. No pretransplant radiotherapy, no remission at the time of transplantation, posttransplant white blood cell count over 10x103/µL, posttransplant positron emission tomography positivity at day 100, and serum albumin of <2.5 g/dL at diagnosis were correlated with progression-free survival. No remission at the time of transplantation, bone marrow positivity at diagnosis, and relapse after AHSCT were significant parameters for overall survival.Conclusion:The major factors affecting the progression-free and overall survival were clearly demonstrated. A CIPI that uses a lactate dehydrogenase level of 500 IU/L worked well for estimating the prognosis. We recommend AHSCT at first complete remission for relapsed cases, and it should also be taken into consideration for patients with high prognostic scores at diagnosis.

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Impact of disease status and stem cell source on the results of reduced intensity conditioning transplant for Hodgkin's lymphoma: a retrospective study from the French Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)

Cited by 39 publications

References 29 publications

Umbilical cord blood transplantation in adults with advanced hodgkin's disease: high incidence of post‐transplant lymphoproliferative disease

Umbilical cord blood transplantation in adults with advanced hodgkin's disease: high incidence of post‐transplant lymphoproliferative disease

The role of hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma

Prognostic Factors and a New Prognostic Index Model for Children and Adolescents with Hodgkin’s Lymphoma Who Underwent Autologous Hematopoietic Stem Cell Transplantation: A Multicenter Study of the Turkish Pediatric Bone Marrow Transplantation Study

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