Reduced intensity conditioning allogeneic stem cell transplantation for Hodgkin's lymphoma: identification of prognostic factors predicting outcome

Robinson, Stephen; Sureda, Anna; Canals, Carmen; Russell, Nigel H.; Caballero, Dolores; Bacigalupo, Andrea; Iriondo, A; Cook, Gordon; Pettitt, Andrew R.; Socié, Gérard; Bonifazi, Francesca; Bosi, Alberto; Michallet, Mauricette; Liakopoulou, Effie; Maertens, Johan; Passweg, Jakob; Clarke, Fiona; Martino, Rodrigo; Schmitz, Norbert

doi:10.3324/haematol.13441

Cited by 158 publications

(152 citation statements)

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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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Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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“…In the literature, the reduced intensity conditioning regimen has shown a lower nonrelapse mortality making this a viable option for patients usually excluded from the conventional allo-SCT [32,33]. There are few published studies on the outcome of reduced intensity conditioning in diffuse large B-cell lymphoma or in aggressive lymphoma [34][35][36][37][38][39]. For patients with relapsed DLBCL, nonrelapse mortality rates with reduced intensity conditioning allogeneic transplantation, with few exceptions [36,40], have been surprisingly high (range 25-38%) [34,41,42].…”

Section: Discussionmentioning

confidence: 99%

Allogeneic hematopoietic stem cell transplantation in patients with diffuse large B cell lymphoma relapsed after autologous stem cell transplantation: A GITMO study

et al. 2012

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When citing, please refer to the published version.Link to this full text: http://hdl.handle.net/ Allogeneic hematopoietic stem cell transplantation in patients with diffuse large B cell lymphoma relapsed after autologous stem cell transplantation: A GITMO study AbstractPatients who relapse after an autologous hematopoietic stem cell transplantation (SCT) have a very poor prognosis. We have retrospectively analyzed diffuse large B cell lymphoma patients who underwent an allo-SCT after an auto-SCT relapse reported in the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) database. From 1995 to 2008, 3449 autologous transplants were reported in the GITMO database. Eight hundred eighty-four patients relapsed or progressed after transplant; 165 patients, 19% of the relapsed patients, were treated with allo-transplant. The stem cell donor was related to the patient in 108 cases. A reduced intensity conditioning regimen was used in 116. After allo-SCT, 72 patients (43%) obtained a complete response and 9 obtained a partial response with an overall response rate of 49%; 84 patients (51%) experienced rapid progression of disease. Ninety-one patients died, 45 due to disease and 46 due to treatment-related mortality. Acute graftversus-host disease was recorded in 57 patients and a chronic GvHD in 38 patients. With a median follow-up of 24 months (2-144) after allo, overall survival (OS) was 39%, and after a median of 21 months (2-138) after allo, progression-free survival (PFS) was 32%. Multivariate analysis indicated that the only factors affecting OS were status at allo-SCT, and those affecting PFS were status at allo-SCT and stem cell donor. This retrospective analysis shows that about one-fifth of patients with diffuse large B cell lymphoma who experience relapse after autologous transplantation may be treated with allogeneic transplantation. Moreover, the only parameter affecting either OS or PFS was the response status at the time of allo-SCT. KeywordsDiffuse large B cell lymphomaSalvage therapyAutologous stem cell transplantationAllogeneic stem cell transplantationReduced intensity conditioning regimenGraft versus lymphoma

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“…27,28 Recently, Robinson et al investigated a population of 285 patients with affected HL who underwent RIC alloSCT and observed that both performance status and disease status at transplantation important clinical parameters for outcome. 29 The kinetics of disease recurrence were quite different in PET-positive patients: In patients with HL, disease progression usually was observed within the first 2 years after alloSCT; whereas most patients with aggressive NHL developed disease recurrence within the first 12 months, and then the curve reached a plateau. Although patients with positive pretransplantation PET scans had a dismal outcome, approximately 30% of them survived for a long period.…”

Section: Discussionmentioning

confidence: 99%

Pretransplantation [18‐F]fluorodeoxyglucose positron emission tomography scan predicts outcome in patients with recurrent Hodgkin lymphoma or aggressive non‐Hodgkin lymphoma undergoing reduced‐intensity conditioning followed by allogeneic stem cell transplantation

Dodero

Crocchiolo

Miceli

et al. 2010

Cancer

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BACKGROUND:The use of positron emission tomography (PET) scanning in Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (HG-NHL) has recognized prognostic value in patients who are receiving chemotherapy or undergoing autologous stem cell transplantation (SCT). In contrast, the role of PET before reduced-intensity conditioning (RIC) and followed by allogeneic SCT has not been investigated to date. METHODS: PET was used to assess 80 patients who had chemosensitive disease (34 patients with HG-NHL and 46 patients with HL) before they underwent allogeneic SCT: 42 patients had negative PET studies, and 38 patients had positive PET studies. Patients underwent allograft from matched related siblings (n ¼ 41) or alternative donors (n ¼ 39). RESULTS: At the time of the last follow-up, 48 patients were alive (60%), and 32 had died. The 3-year cumulative incidence of nonrecurrence mortality and disease recurrence was 17% and 40%, respectively. The cumulative incidence of disease recurrence was significantly lower in the PET-negative patients (25% vs 56%; P ¼ .007), but there was no significant difference between the patients with or without chronic graft-versus-host disease (P ¼ .400). The patients who had negative PET studies before undergoing allogenic SCT also had significantly better outcomes in terms of 3-year overall survival (76% vs 33%; P ¼ .001) and 3-year progression-free survival (73% vs 31%; P ¼ .001). On multivariate analysis, overall survival was influenced by PET status (hazard ratio [HR], 3.35), performance status (HR, 5.15), and type of donor (HR, 6.26 for haploidentical vs sibling; HR, 1.94 for matched unrelated donor vs sibling). CONCLUSIONS: The current results indicated that PET scanning appears to be an accurate tool for assessing prognosis in patients who are eligible for RIC allografting. Cancer 2010;116:5001-11.

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Reduced intensity conditioning allogeneic stem cell transplantation for Hodgkin's lymphoma: identification of prognostic factors predicting outcome

Cited by 158 publications

References 32 publications

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

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

Allogeneic hematopoietic stem cell transplantation in patients with diffuse large B cell lymphoma relapsed after autologous stem cell transplantation: A GITMO study

Pretransplantation [18‐F]fluorodeoxyglucose positron emission tomography scan predicts outcome in patients with recurrent Hodgkin lymphoma or aggressive non‐Hodgkin lymphoma undergoing reduced‐intensity conditioning followed by allogeneic stem cell transplantation

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