Haploidentical transplantation with post-infusion cyclophosphamide in advanced Hodgkin lymphoma

Bone Marrow Transplant. 2017 May;52(5):683-688. doi: 10.1038/bmt.2016.348. Epub 2017 Jan 16.

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.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Cyclophosphamide / therapeutic use*
  • Female
  • Graft vs Host Disease / drug therapy
  • Graft vs Host Disease / prevention & control
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation
  • Prognosis
  • Survival Analysis
  • Transplantation, Haploidentical / methods*
  • Transplantation, Haploidentical / mortality
  • Young Adult

Substances

  • Cyclophosphamide