Busulfan-based reduced intensity conditioning regimens for haploidentical transplantation in relapsed/refractory Hodgkin lymphoma: Spanish multicenter experience.
Jorge GayosoP BalsalobreM J PascualC Castilla-LlorenteL López-CorralM KwonD SerranoJ L PiñanaP HerreraC FerráC PascualI HerasPau MontesinosA ZabalzaL BentoA FigueraI BuñoJ L Díez-MartínPublished in: Bone marrow transplantation (2016)
Relapsed or refractory Hodgkin lymphoma (advanced HL) still remains a therapeutic challenge. Recently, unmanipulated haploidentical related donor transplant with reduced conditioning regimen (HAPLO-RIC) and post-transplant cyclophosphamide (PT-Cy) as GvHD prophylaxis has became a promising rescue strategy potentially available to almost every patient. This paper reports our multicenter experience using an IV busulfan-based HAPLO-RIC regimen and PT-Cy in the treatment of 43 patients with advanced HL. Engraftment occurred in 42 patients (97.5%), with a median time to neutrophil and platelet recovery of 18 and 26 days. Cumulative incidences of grades II-IV acute GvHD and chronic GvHD were 39% and 19%, respectively. With a median follow-up of 25.5 months for survivors, 27 patients are alive, with 22 of them disease free. Cumulative incidences of 1-year non-relapse mortality and relapse at 2 years were 21% and 24%, respectively. The estimated 2-year event-free survival (EFS) and overall survival (OS) were 48% and 58%, respectively. CR prior to HAPLO-RIC correlated with better EFS (78.5% vs 33.5%; P=0.015) and OS (86% vs 46%; P=0.044). Our findings further confirm prior reports using HAPLO-RIC in advanced HL in a multicenter approach employing an IV busulfan-based conditioning regimen.
Keyphrases
- hodgkin lymphoma
- free survival
- allogeneic hematopoietic stem cell transplantation
- acute lymphoblastic leukemia
- stem cell transplantation
- acute myeloid leukemia
- end stage renal disease
- bone marrow
- ejection fraction
- newly diagnosed
- peripheral blood
- cross sectional
- double blind
- case report
- young adults
- drug induced
- liver failure
- cardiovascular disease
- cardiovascular events
- respiratory failure
- clinical trial
- cell therapy
- diffuse large b cell lymphoma
- patient reported
- high intensity
- multiple myeloma
- mesenchymal stem cells
- intensive care unit
- combination therapy