RT Journal Article
T1 Allogeneic stem cell transplantation after reduced intensity conditioning in patients with relapsed or refractory Hodgkin's lymphoma. Results of the HDR-ALLO study - a prospective clinical trial by the Grupo Español de Linfomas/Trasplante de Médula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation.
A1 Sureda, Anna
A1 Canals, Carme
A1 Arranz, Reyes
A1 Caballero, Dolores
A1 Ribera, Josep Maria
A1 Brune, Mats
A1 Passweg, Jacob
A1 Martino, Rodrigo
A1 Valcárcel, David
A1 Besalduch, Joan
A1 Duarte, Rafael
A1 León, Angel
A1 Pascual, Maria Jesus
A1 García-Noblejas, Ana
A1 López Corral, Lucia
A1 Xicoy, Bianca
A1 Sierra, Jordi
A1 Schmitz, Norbert
K1 Allogeic stem cell transplantation
K1 Reduced intensity conditioning
K1 Hodgkin's lymphoma relapsed
K1 Refractory
K1 Acondicionamiento para el trasplante
K1 Enfermedad de Hodgkin
K1 enfermedad injerto contra huésped
K1 Estudios prospectivos
AB BACKGROUNDAlthough Hodgkin's lymphoma is a highly curable disease with modern chemotherapy protocols, some patients are primary refractory or relapse after first-line chemotherapy or even after high-dose therapy and autologous stem cell transplantation. We investigated the potential role of allogeneic stem cell transplantation in this setting.DESIGN AND METHODSIn this phase II study 92 patients with relapsed Hodgkin's lymphoma and an HLA-identical sibling, a matched unrelated donor or a one antigen mismatched, unrelated donor were treated with salvage chemotherapy followed by reduced intensity allogeneic transplantation. Fourteen patients showed refractory disease and died from progressive lymphoma with a median overall survival after trial entry of 10 months (range, 6-17). Seventy-eight patients proceeded to allograft (unrelated donors, n=23). Fifty were allografted in complete or partial remission and 28 in stable disease. Fludarabine (150 mg/m(2) iv) and melphalan (140 mg/m(2) iv) were used as the conditioning regimen. Anti-thymocyte globulin was additionally used as graft-versus-host-disease prophylaxis for recipients of grafts from unrelated donors.RESULTSThe non-relapse mortality rate was 8% at 100 days and 15% at 1 year. Relapse was the major cause of failure. The progression-free survival rate was 47% at 1 year and 18% at 4 years from trial entry. For the allografted population, the progression-free survival rate was 48% at 1 year and 24% at 4 years. Chronic graft-versus-host disease was associated with a lower incidence of relapse. Patients allografted in complete remission had a significantly better outcome. The overall survival rate was 71% at 1 year and 43% at 4 years.CONCLUSIONSAllogeneic stem cell transplantation can result in long-term progression-free survival in heavily pre-treated patients with Hodgkin's lymphoma. The reduced intensity conditioning approach significantly reduced non-relapse mortality; the high relapse rate represents the major remaining challenge in this setting. The HDR-Allo trial was registered in the European Clinical Trials Database (EUDRACT, https://eudract.ema.europa.eu/) with number 02-0036.
PB Ferrata Storti Foundation
SN 0390-6078
YR 2012
FD 2012-02
LK http://hdl.handle.net/10668/1287
UL http://hdl.handle.net/10668/1287
LA en
NO Sureda A, Canals C, Arranz R, Caballero D, Ribera JM, Brune M, et al. Allogeneic stem cell transplantation after reduced intensity conditioning in patients with relapsed or refractory Hodgkin's lymphoma. Results of the HDR-ALLO study - a prospective clinical trial by the Grupo Español de Linfomas/Trasplante de Médula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Haematologica. 2012; 97(2):310-7
NO Clinical Trial, Phase II; Journal Article; Multicenter Study;
DS RISalud
RD Apr 12, 2025