Comparison of Outcomes of HLA-Matched Related, Unrelated, or HLA-Haploidentical Related Hematopoietic Cell Transplantation following Nonmyeloablative Conditioning for Relapsed or Refractory Hodgkin Lymphoma

被引:206
作者
Burroughs, Lauri M. [1 ]
O'Donnell, Paul V. [1 ]
Sandmaier, Brenda M. [1 ]
Storer, Barry E. [1 ]
Luznik, Leo [2 ]
Symons, Heather J. [2 ]
Jones, Richard J. [2 ]
Ambinder, Richard F. [2 ]
Maris, Michael B.
Blume, Karl G. [3 ]
Niederwieser, Dietger W. [4 ]
Bruno, Benedetto [5 ]
Maziarz, Richard T. [6 ]
Pulsipher, MichaelA. [7 ]
Petersen, Finn B. [8 ]
Storb, Rainer [1 ]
Fuchs, Ephraim J. [2 ]
Maloney, David G. [1 ]
机构
[1] Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA
[2] Sidney Kimmel Comprehens Canc Ctr John Hopkins, Baltimore, MD USA
[3] Stanford Univ, Palo Alto, CA 94304 USA
[4] Univ Leipzig, Leipzig, Germany
[5] Univ Turin, Turin, Italy
[6] Oregon Hlth & Sci Univ, Portland, OR 97201 USA
[7] Univ Utah, Salt Lake City, UT USA
[8] Intermt Blood & Marrow Transplant Program, Salt Lake City, UT USA
关键词
Hodgkin lymphoma; Hematopoietic cell transplantation; Nonmyeloablative;
D O I
10.1016/j.bbmt.2008.08.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We compared the outcome of nonmyeloablative allogeneic hematopoietic cell transplantation (HCT) for patients with relapsed or refractory Hodgkin lymphoma (HL) based on donor cell source. Ninety patients with HL were treated with nonmyeloablative conditioning followed by HCT from HLA-matched related, n = 38, unrelated, n = 24, or HLA-haploidentical related, n = 28 donors. Patients were heavily pretreated with a median of 5 regimens and most patients had failed autologous HCT (92%) and local radiation therapy (83%). With a median follow-up of 25 months, 2-year overall survivals, progress ion-free survivals (OS)/(PFS), and incidences of relapsed/progressive disease were 53%, 23%, and 56% (HLA-matched related), 58%, 29%, and 63% (unrelated), and 58%, 51%, and 40% (HLA-haploidentical related), respectively. Nonrelapse mortality (NRM) was significantly lower for HLA-haploidentical related (P = .02) recipients compared to HLA-matched related recipients. There were also significantly decreased risks of relapse for HLA-haploidentical related recipients compared to HLA-matched related (P = .01) and unrelated (P = .03) recipients. The incidences of acute grades III-IV and extensive chronic graft-versus-host disease (aGVHD, cGVHD) were 16%/50% (HLA-matched related), 8%/63% (unrelated), and 11%/35% (HLA-haploidentical related). These data suggested that salvage allogeneic HCT using nonmyeloablative conditioning provided antitumor activity in patients with advanced HL; however, disease relapse/progression continued to be major problems. Importantly, alternative donor stem cell sources are a viable option.
引用
收藏
页码:1279 / 1287
页数:9
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