Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin's lymphoma

Bone Marrow Transplant. 2014 Feb;49(2):190-4. doi: 10.1038/bmt.2013.166. Epub 2013 Nov 4.

Abstract

Twenty-six patients with advanced Hodgkin's disease received a related HLA haploidentical unmanipulated BMT, following a non-myeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose post-transplantation CY (PT-CY), mycophenolate and a calcineurin inhibitor. All patients had received a previous autograft, and 65% had active disease at the time of BMT. Sustained engraftment of donor cells occurred in 25 patients (96%), with a median time to neutrophil recovery (>0.5 × 10(9)/L) and platelet recovery (>20 × 10(9)/L) of +18 and +23 days from BMT. The incidence of grade II-IV acute GVHD and of chronic GVHD was 24% and 8%, respectively. With a median follow-up of 24 months (range 18-44) 21 patients are alive, 20 disease free. The cumulative incidence of TRM and relapse was 4% and 31%, respectively. The actuarial 3-year survival is 77%, the actuarial 3-year PFS is 63%. In conclusion, we confirm that high-dose PT-CY is effective as prophylaxis of GVHD after HLA haploidentical BMT, can prevent rejection and does not appear to eliminate the allogeneic graft versus lymphoma effect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Marrow Transplantation / adverse effects
  • Bone Marrow Transplantation / methods*
  • Female
  • Genotype
  • Graft vs Host Disease / prevention & control*
  • Hodgkin Disease / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Transplantation Conditioning / adverse effects
  • Transplantation Conditioning / methods*
  • Young Adult