Myeloablative versus reduced intensity allogeneic stem cell transplantation for relapsed/refractory Hodgkin's lymphoma in recent years: a retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation
Por:
Genadieva-Stavrik, S, Boumendil, A, Dreger, P, Peggs, K, Briones, J, Corradini, P, Bacigalupo, A, Socie, G, Bonifazi, F, Finel, H, Velardi, A, Potter, M, Bruno, B, Castagna, L, Malladi, R, Russell, N, Sureda, A
Publicada:
1 dic 2016
Resumen:
Background: To evaluate long-term outcome of myeloablative allogeneic stem cell transplantation (allo-SCT) (MAC) versus reduced-intensity allo-SCT (RIC) in patients with relapsed/refractory Hodgkin's lymphoma (HL) in recent years.
Patients and methods: A total of 312 patients (63 MAC and 249 RIC) with relapsed/refractory HL who received allo-SCT between 2006 and 2010 and were reported to the EBMT Database were included in the study.
Results: With a median follow-up for alive patients of 56 (26-73) months, there were no significant differences in non-relapse mortality (NRM) between MAC and RIC. Relapse rate (RR) was somewhat lower in the MAC group (41% versus 52% at 24 months, P = 0.16). This lower RR translated into a marginal improvement in event-free survival (EFS) for the MAC group (48% versus 36% at 24 months, P = 0.09) with no significant differences in overall survival (73% for MAC and 62% for RIC at 24 months, P = 0.13). Multivariate analysis after adjusting for disease status at the time of allo-SCT showed that the use of MAC was of borderline statistical significance for predicting a lower RR and EFS [HR 0.7, 95% CI (0.5-1.0), P = 0.1] and [HR 0.7, 95% CI (0.5-1.0), P = 0.07], respectively, after allo-SCT.
Conclusions: With modern transplant practices, the NRM associated with MAC for HL has strongly decreased, resulting into non-significant improvement of EFS because of a somewhat better disease control compared with RIC transplants. The intensity of conditioning regimens should be considered when designing individual allo-SCT strategies or clinical trials in patients with relapsed/refractory HL.
Filiaciones:
Genadieva-Stavrik, S:
Univ Hematol Clin, Med Fac Skopje, BMT Unit, Skopje, Macedonia
Boumendil, A:
EBMT Lymphoma Working Party, Paris, France
Dreger, P:
EBMT Lymphoma Working Party, Paris, France
Heidelberg Univ, Dept Internal Med 5, Heidelberg, Germany
Peggs, K:
Univ Coll London Hosp NHS Trust, Hematol, London, England
Briones, J:
Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain
Corradini, P:
Univ Milan, IRCCS Ist Nazl Tumori, Milan, Italy
Bacigalupo, A:
Osped San Martino Genova, Hematol, Genoa, Italy
Socie, G:
Hop St Louis, Haematol, Paris, France
Bonifazi, F:
Orsola Malpighi Univ Hosp, Hematol, Bologna, Italy
Finel, H:
EBMT Lymphoma Working Party, Paris, France
Velardi, A:
Osped Santa Maria Misericordia, Hematol, Perugia, Italy
Potter, M:
Royal Marsden Hosp, Hematol, London, England
Royal Marsden Hosp, Hematol, Sutton, Surrey, England
Bruno, B:
Azienda Osped Univ Citta Salute & Sci, Dept Hematol, Turin, Italy
Castagna, L:
Humanitas Clin & Res Ctr, Humanitas Canc Ctr, Dept Hematol & Oncol, Milan, Italy
Malladi, R:
Queen Elizabeth Hosp Birmingham NHS Fdn Trust, Ctr Clin Haematol, Birmingham, W Midlands, England
Russell, N:
Nottingham Univ Hosp NHS Trust, Haematol, Nottingham, England
Sureda, A:
Hosp Duran I Reynals, Dept Hematol, Inst Catala Oncol, Gran Via 199-203, Barcelona 08908, Spain
Bronze, Green Submitted
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