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Haploidentical transplantation with post-infusion cyclophosphamide in advanced Hodgkin lymphoma.[Erratum appears in Bone Marrow Transplant. 2017 May;52(5):797; PMID: 28465624]
Castagna, L., Bramanti, S., Devillier, R., Sarina, B., Crocchiolo, R., Furst, S., El-Cheikh, J., Granata, A., Faucher, C., Harbi, S., et al
Bone Marrow Transplantation. 2017;52(5):683-688
Abstract
We investigated the use of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in the treatment of advanced Hodgkin lymphoma (HL). Sixty-two consecutive HL patients underwent haplo-HSCT. Unmanipulated stem cells and post-transplant cyclophosphamide were given to all patients as GVHD prophylaxis. At 100 days, the cumulative incidence of grades 2-3 and grades 3-4 acute GVHD was 23% and 4%, respectively. The chronic GVHD (cGVHD) cumulative incidence was 16%, with one patient experiencing severe cGVHD. The 3-year OS, PFS, relapse rates and 1-year non-relapse mortality (NRM) were 63%, 59%, 21% and 20%, respectively. Uncontrolled disease status and high hematopoietic cell transplantation comorbidity index (HCT-CI) were associated with lower OS, whereas PBSC was an independent protective factor. Uncontrolled disease and HCT-CI >2 was predictive for NRM. Finally, disease status other than CR was predictive of relapse. In conclusion, haplo-HSCT is a valid treatment in advanced HL, offering excellent rates of survival and acceptable toxicities.
