Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Dec 23;3(24):4264-4270.
doi: 10.1182/bloodadvances.2019001016.

Allo-HSCT in transplant-naïve patients with Hodgkin lymphoma: a single-arm, multicenter study

Emma Das-Gupta  1 , Kirsty J Thomson  2 , Adrian J C Bloor  3 , Andrew D Clark  4 , Stephen Mackinnon  5   6 , Irfan Kayani  2 , Laura Clifton-Hadley  7 , Pip Patrick  7 , Nadjet El-Mehidi  7 , Anthony Lawrie  7 , Amy A Kirkwood  7 , Nigel H Russell  1 , David C Linch  2   6 , Karl S Peggs  2   6
Affiliations
Multicenter Study

Allo-HSCT in transplant-naïve patients with Hodgkin lymphoma: a single-arm, multicenter study

Emma Das-Gupta et al. Blood Adv. .

Abstract

We evaluated the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in transplant-naïve patients with relapsed/refractory Hodgkin lymphoma (HL) who failed to attain metabolic complete response (mCR) to 1 to 2 lines of salvage chemotherapyThose with residual but nonprogressive disease assessed by positron emission tomography/computed tomography scanning were eligible. An additional 1 to 2 cycles of salvage therapy were permissible in those with progressive disease or when required to bridge to allo-HSCT, with additional imaging at baseline before transplantation. Conditioning consisted of carmustine, etoposide, cytarabine, melphalan, and alemtuzumab. Donor lymphocyte infusions (DLI) were administered for mixed chimerism or residual or relapsed disease. Eleven patients had sibling donors, 13 had HLA-matched unrelated donors, and 7 had HLA-mismatched unrelated donors. There were no graft failures, and no episodes of grade 4 acute graft-versus-host disease (GVHD); only 19.4% of patients had grade 2 to 3 GVHD, and 22.2% had extensive chronic GVHD. The non-relapse mortality rate was 16.1% (95% confidence interval [CI], 7.1%-34.5%). Relapse incidence was 18.7% (95% CI, 8.2%-39.2%). The study met its primary objective, with a 3-year progression-free survival of 67.7% (95% CI, 48.4%-81.2%). Survival outcomes were equivalent in those with residual metabolically active disease immediately before transplantation (n = 24 [70.8%; 95% CI, 17.2%-83.7%]). Two of the 5 patients who relapsed received DLI and remained in mCR at latest follow-up, with a 3-year overall survival of 80.7% (95% CI, 61.9%-90.8%). We demonstrate encouraging results that establish a potential role for allo-HSCT in selected high-risk patients with HL. This trial was registered at www.clinicaltrials.gov as #NCT00908180.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
CONSORT diagram. D110, day 100.
Figure 2.
Figure 2.
Survival outcomes. PFS (A) and OS (B) for the cohort of 31 patients. (C) PFS according to pretransplant disease status. NRM (D) and relapse incidence (E).
See this image and copyright information in PMC

References

    1. Schmitz N, Pfistner B, Sextro M, et al. ; Lymphoma Working Party of the European Group for Blood and Marrow Transplantation . Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet. 2002;359(9323):2065-2071. - PubMed
    1. Brice P, Bouabdallah R, Moreau P, et al. . Prognostic factors for survival after high-dose therapy and autologous stem cell transplantation for patients with relapsing Hodgkin’s disease: analysis of 280 patients from the French registry. Société Française de Greffe de Moëlle. Bone Marrow Transplant. 1997;20(1):21-26. - PubMed
    1. Sureda A, Arranz R, Iriondo A, et al. ; Grupo Español de Linformas/Transplante Autólogo de Médula Osea Spanish Cooperative Group . Autologous stem-cell transplantation for Hodgkin’s disease: results and prognostic factors in 494 patients from the Grupo Español de Linfomas/Transplante Autólogo de Médula Osea Spanish Cooperative Group. J Clin Oncol. 2001;19(5):1395-1404. - PubMed
    1. Bröckelmann PJ, Müller H, Casasnovas O, et al. . Risk factors and a prognostic score for survival after autologous stem-cell transplantation for relapsed or refractory Hodgkin lymphoma. Ann Oncol. 2017;28(6):1352-1358. - PubMed
    1. Shah GL, Yahalom J, Matasar MJ, et al. . Risk factors predicting outcomes for primary refractory Hodgkin lymphoma patients treated with salvage chemotherapy and autologous stem cell transplantation. Br J Haematol. 2016;175(3):440-447. - PMC - PubMed

Publication types

MeSH terms

Associated data