TY - JOUR
T1 - Haploidentical related donor compared to HLA-identical donor transplantation for chemosensitive Hodgkin lymphoma patients.
AU - Castagna, Luca
AU - Busca, Alessandro
AU - Bramanti, Stefania
AU - Raiola Anna, Maria
AU - Malagola, Michele
AU - Ciceri, Fabio
AU - Arcese, William
AU - Vallisa, Daniele
AU - Patriarca, Francesca
AU - Specchia, Giorgina
AU - Raimondi, Roberto
AU - Devillier, Raynier
AU - Furst, Sabine
AU - Giordano, Laura
AU - Sarina, Barbara
AU - Mariotti, Jacopo
AU - Olivieri, Attilio
AU - Bouabdallah, Reda
AU - Carlo-Stella, Carmelo
AU - Rambaldi, Alessandro
AU - Santoro, Armando
AU - Corradini, Paolo
AU - Bacigalupo, Andrea
AU - Bonifazi, Francesca
AU - Blaise, Didier
PY - 2020/11/1
Y1 - 2020/11/1
N2 - BACKGROUND: Allogeneic stem cell transplantation from haploidentical donor using an unmanipulated graft and post-transplantation cyclophosphamide (PT-Cy) is growing. Haploidentical transplantation with PT-Cy showed a major activity in Hodgkin lymphoma (HL), reducing the relapse incidence. The most important predictive factor of survival and toxicity was disease status before transplantation, which was better in patients with well controlled disease. METHODS: We included 198 HL in complete (CR) or partial remission (PR) before transplantation. Sixty-five patients were transplanted from haploidentical donor and 133 from a HLA identical donor (both sibling and unrelated donors). Survival analysis was defined according to the EBMT criteria. Survival curves were generated by using Kaplan-Meier method and differences between groups were compared by the log rank test or by the log rank test for trend when appropriated. RESULTS: The PFS, OS, and RI were significantly better in patients in CR compared to PR (559.001, 745.03, 275textless 0.001, respectively). The 2-year PFS was significantly better for HAPLO than HLA-id (637 p = 0.03), without difference in OS. The 1-year NRM was not different. The 2-year relapse incidence (RI) was lower in the HAPLO group (244 p = 0.008). Patients in CR receiving haplo HSCT showed higher 2-year PFS and lower 2-year RI than those allografted with HLA-id donor (757 p textless 0.001 and 114 p textless 0.001, respectively). In multivariate analysis, donor type and disease status before transplantation were independent predictors of PFS as well as they predict the risk of relapse. Disease status at transplantation and age were independently associated to OS. CONCLUSIONS: Nonetheless this is a retrospective study, limiting the wide applicability of results, data from this analysis suggest that HLA mismatch can induce a strong graft versus lymphoma effect leading to an enhanced PFS.
AB - BACKGROUND: Allogeneic stem cell transplantation from haploidentical donor using an unmanipulated graft and post-transplantation cyclophosphamide (PT-Cy) is growing. Haploidentical transplantation with PT-Cy showed a major activity in Hodgkin lymphoma (HL), reducing the relapse incidence. The most important predictive factor of survival and toxicity was disease status before transplantation, which was better in patients with well controlled disease. METHODS: We included 198 HL in complete (CR) or partial remission (PR) before transplantation. Sixty-five patients were transplanted from haploidentical donor and 133 from a HLA identical donor (both sibling and unrelated donors). Survival analysis was defined according to the EBMT criteria. Survival curves were generated by using Kaplan-Meier method and differences between groups were compared by the log rank test or by the log rank test for trend when appropriated. RESULTS: The PFS, OS, and RI were significantly better in patients in CR compared to PR (559.001, 745.03, 275textless 0.001, respectively). The 2-year PFS was significantly better for HAPLO than HLA-id (637 p = 0.03), without difference in OS. The 1-year NRM was not different. The 2-year relapse incidence (RI) was lower in the HAPLO group (244 p = 0.008). Patients in CR receiving haplo HSCT showed higher 2-year PFS and lower 2-year RI than those allografted with HLA-id donor (757 p textless 0.001 and 114 p textless 0.001, respectively). In multivariate analysis, donor type and disease status before transplantation were independent predictors of PFS as well as they predict the risk of relapse. Disease status at transplantation and age were independently associated to OS. CONCLUSIONS: Nonetheless this is a retrospective study, limiting the wide applicability of results, data from this analysis suggest that HLA mismatch can induce a strong graft versus lymphoma effect leading to an enhanced PFS.
KW - Hodgkin lymphoma
KW - Haploidentical transplantation
KW - Reduced intensity conditioning regimen
U2 - 10.1186/s12885-020-07602-w
DO - 10.1186/s12885-020-07602-w
M3 - Article
SN - 1471-2407
VL - 20
SP - 1140
JO - BMC Cancer
JF - BMC Cancer
IS - 1
ER -