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

Lauri M. Burroughs, Paul V. O'Donnell, Brenda M. Sandmaier, Barry E. Storer, Leo Luznik, Heather Symons, Richard J Jones, Richard F Ambinder, Michael B. Maris, Karl G. Blume, Dietger W. Niederwieser, Benedetto Bruno, Richard T. Maziarz, Michael A. Pulsipher, Finn B. Petersen, Rainer Storb, Ephraim J Fuchs, David G. Maloney

Research output: Contribution to journalArticle

Abstract

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, progression-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.

Original languageEnglish (US)
Pages (from-to)1279-1287
Number of pages9
JournalBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Volume14
Issue number11
DOIs
StatePublished - Nov 2008

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Cell Transplantation
Hodgkin Disease
Tissue Donors
Recurrence
Incidence
Graft vs Host Disease
Disease-Free Survival
Disease Progression
Radiotherapy
Stem Cells
Survival
Mortality

Keywords

  • Hematopoietic cell transplantation
  • Hodgkin lymphoma
  • Nonmyeloablative

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Comparison of Outcomes of HLA-Matched Related, Unrelated, or HLA-Haploidentical Related Hematopoietic Cell Transplantation following Nonmyeloablative Conditioning for Relapsed or Refractory Hodgkin Lymphoma. / Burroughs, Lauri M.; O'Donnell, Paul V.; Sandmaier, Brenda M.; Storer, Barry E.; Luznik, Leo; Symons, Heather; Jones, Richard J; Ambinder, Richard F; Maris, Michael B.; Blume, Karl G.; Niederwieser, Dietger W.; Bruno, Benedetto; Maziarz, Richard T.; Pulsipher, Michael A.; Petersen, Finn B.; Storb, Rainer; Fuchs, Ephraim J; Maloney, David G.

In: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Vol. 14, No. 11, 11.2008, p. 1279-1287.

Research output: Contribution to journalArticle

Burroughs, Lauri M. ; O'Donnell, Paul V. ; Sandmaier, Brenda M. ; Storer, Barry E. ; Luznik, Leo ; Symons, Heather ; Jones, Richard J ; Ambinder, Richard F ; Maris, Michael B. ; Blume, Karl G. ; Niederwieser, Dietger W. ; Bruno, Benedetto ; Maziarz, Richard T. ; Pulsipher, Michael A. ; Petersen, Finn B. ; Storb, Rainer ; Fuchs, Ephraim J ; Maloney, David G. / Comparison of Outcomes of HLA-Matched Related, Unrelated, or HLA-Haploidentical Related Hematopoietic Cell Transplantation following Nonmyeloablative Conditioning for Relapsed or Refractory Hodgkin Lymphoma. In: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2008 ; Vol. 14, No. 11. pp. 1279-1287.
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abstract = "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, progression-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.",
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AU - O'Donnell, Paul V.

AU - Sandmaier, Brenda M.

AU - Storer, Barry E.

AU - Luznik, Leo

AU - Symons, Heather

AU - Jones, Richard J

AU - Ambinder, Richard F

AU - Maris, Michael B.

AU - Blume, Karl G.

AU - Niederwieser, Dietger W.

AU - Bruno, Benedetto

AU - Maziarz, Richard T.

AU - Pulsipher, Michael A.

AU - Petersen, Finn B.

AU - Storb, Rainer

AU - Fuchs, Ephraim J

AU - Maloney, David G.

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N2 - 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, progression-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.

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