Reduced-intensity allogeneic stem cell transplantation in relapsed and refractory Hodgkin's disease: Low transplant-related mortality and impact of intensity of conditioning regimen

TY - JOUR

T1 - Reduced-intensity allogeneic stem cell transplantation in relapsed and refractory Hodgkin's disease

T2 - Low transplant-related mortality and impact of intensity of conditioning regimen

AU - Anderlini, Panderli

AU - Saliba, R.

AU - Acholonu, S.

AU - Okoroji, G. J.

AU - Donato, M.

AU - Giralt, S.

AU - Andersson, B.

AU - Ueno, N. T.

AU - Khouri, I.

AU - De Lima, M.

AU - Hosing, C.

AU - Cohen, A.

AU - Ippoliti, C.

AU - Romaguera, J.

AU - Rodriguez, M. A.

AU - Pro, B.

AU - Fayad, L.

AU - Goy, A.

AU - Younes, A.

AU - Champlin, R. E.

PY - 2005/5

Y1 - 2005/5

N2 - A total of 40 patients with relapsed/refractory Hodgkin's disease (HD) underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT) from an HLA-identical sibling (n = 20) or a matched unrelated donor (n = 20). The median age was 31 years (range 18-58). Disease status at allo-SCT was refractory relapse (n = 14) or sensitive relapse (n = 26). The conditioning regimens were fludarabinelcyclophosphamide ± autithymocyte globulin (n =14), a less intensive regimen, and fludarabine-melphalan (FM) (n = 26), a more intensive one. The two groups had similar prognostic factors. The median time to neutrophil recovery (ie absolute neutrophil count ≥ 500/μl) was 12 days (range 10-24). The median time to platelet recovery (ie platelet count ≥ 20 000/μl) was 17 days (range 7-132). Day 100 and cumulative (18-month) transplant-related mortalities (TRMs) were 5 and 22%. Twenty-four patients (60%) are alive (14 in complete remission or complete remission, unconfirmed/uncertain) with a median follow-up of 13 mouths (4-78). In all, 16 patients expired (TRM n = 8, disease progression n = 8). FM patients had better overall survival (73 vs 39% at 18 months; P = 0.03), and a trend towards better progression-free survival (37 vs 21% at 18 months; P = 0.2). RIC allo-SCT is feasible in relapsed/refractory HD patients with a low TRM. The intensity of the preparative regimen affects survival.

AB - A total of 40 patients with relapsed/refractory Hodgkin's disease (HD) underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT) from an HLA-identical sibling (n = 20) or a matched unrelated donor (n = 20). The median age was 31 years (range 18-58). Disease status at allo-SCT was refractory relapse (n = 14) or sensitive relapse (n = 26). The conditioning regimens were fludarabinelcyclophosphamide ± autithymocyte globulin (n =14), a less intensive regimen, and fludarabine-melphalan (FM) (n = 26), a more intensive one. The two groups had similar prognostic factors. The median time to neutrophil recovery (ie absolute neutrophil count ≥ 500/μl) was 12 days (range 10-24). The median time to platelet recovery (ie platelet count ≥ 20 000/μl) was 17 days (range 7-132). Day 100 and cumulative (18-month) transplant-related mortalities (TRMs) were 5 and 22%. Twenty-four patients (60%) are alive (14 in complete remission or complete remission, unconfirmed/uncertain) with a median follow-up of 13 mouths (4-78). In all, 16 patients expired (TRM n = 8, disease progression n = 8). FM patients had better overall survival (73 vs 39% at 18 months; P = 0.03), and a trend towards better progression-free survival (37 vs 21% at 18 months; P = 0.2). RIC allo-SCT is feasible in relapsed/refractory HD patients with a low TRM. The intensity of the preparative regimen affects survival.

KW - Allogeneic stem cell transplantation

KW - Bone marrow transplantation

KW - Hodgkin's disease

KW - Hodgkin's lymphoma

KW - Peripheral blood stem cell transplantation

UR - https://www.scopus.com/pages/publications/21044439959

U2 - 10.1038/sj.bmt.1704942

DO - 10.1038/sj.bmt.1704942

M3 - Article

C2 - 15806128

SN - 0268-3369

VL - 35

SP - 943

EP - 951

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

IS - 10

ER -