Lower Graft-versus-Host Disease and Relapse Risk in Post-Transplant Cyclophosphamide-Based Haploidentical versus Matched Sibling Donor Reduced-Intensity Conditioning Transplant for Hodgkin Lymphoma

Classic Hodgkin lymphoma (cHL) patients with relapsed or refractory disease may benefit from allogeneic hematopoietic cell transplantation (allo-HCT), but many lack a matched sibling donor (MSD). Herein, we compare outcomes of 2 reduced-intensity conditioning (RIC) HCT platforms in cHL: T cell-reple...

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Detalles Bibliográficos
Autores: Ahmed, Sairah|||0000-0001-7302-8299, Kanakry, Jennifer A., Ahn, Kwang Woo|||0000-0003-4567-8037, Litovich, Carlos Alejandro, Abdel-Azim, Hisham, Aljurf, Mahmoud Deeb, Bacher, Vera Ulrike, Bejanyan, Nelli|||0000-0003-0194-7338, Cohen, Jonathon B., Farooq, Umar|||0000-0001-7891-9891, Fuchs, Ephraim Joseph, Bolaños-Meade, Javier, Ghosh, Nilanjan S., Herrera, Álex F.|||0000-0002-9665-7415, Hossain, Nasheed|||0000-0002-3278-655X, Inwards, David|||0000-0002-6894-9277, Kanate, Abraham Sebastian, Martino Bofarull, Rodrigo|||0000-0001-5143-4042, Munshi, Pashna|||0000-0002-8079-9443, Murthy, Hemant S.|||0000-0003-4534-4248, Mussetti, Alberto|||0000-0002-4088-036X, Nieto, Yago|||0000-0001-6034-8939, Perales, Miguel-Angel|||0000-0002-5910-4571, Romee, Rizwan|||0000-0001-9077-4736, Savani, Bipin|||0000-0002-3304-9965, Seo, Sachiko|||0000-0002-4308-2152, Wirk, Baldeep Mona, Yared, Jean A.., Sureda, Anna|||0000-0002-1238-6970, Fenske, Timothy S., Hamadani, Mehdi|||0000-0001-5372-510X
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:285084
Acceso en línea:https://ddd.uab.cat/record/285084
https://dx.doi.org/urn:doi:10.1016/j.bbmt.2019.05.025
Access Level:acceso abierto
Palabra clave:Allogeneic transplantation
Alternative donor
Haploidentical transplantation
Hodgkin lymphoma
Descripción
Sumario:Classic Hodgkin lymphoma (cHL) patients with relapsed or refractory disease may benefit from allogeneic hematopoietic cell transplantation (allo-HCT), but many lack a matched sibling donor (MSD). Herein, we compare outcomes of 2 reduced-intensity conditioning (RIC) HCT platforms in cHL: T cell-replete related donor haploidentical (haplo) HCT with a post-transplant cyclophosphamide (PTCy)-based approach versus an MSD/calcineurin inhibitor (CNI)-based approach. The study included 596 adult patients who underwent a first RIC allo-HCT for cHL between 2008 and 2016 using either a haplo-PTCy (n = 139) or MSD/CNI-based (n = 457) approach. Overall survival (OS) was the primary endpoint. Secondary endpoints included acute graft-versus-host disease (aGVHD) and chronic GVHD (cGVHD), nonrelapse mortality (NRM), relapse/progression, and progression-free survival (PFS). On multivariate analysis, there was no significant difference between haplo/PTCy and MDS/CNI-based approaches in terms of OS (hazard ratio [HR], 1.07; 95% confidence interval [CI],.79 to 1.45; P =.66) or PFS (HR,.86; 95% CI,.68 to 1.10; P =.22). Haplo/PTCy was associated with a significantly higher risk of grades II to IV aGVHD (odds ratio [OR], 1.73, 95% CI, 1.16 to 2.59; P =.007), but the risk of grades III to IV aGVHD was not significantly different between the 2 cohorts (OR,.61; 95% CI,.29 to 1.27; P =.19). The haplo/PTCy platform provided a significant reduction in cGVHD risk (HR,.45; 95% CI,.32 to.64; P <.001), and a significant reduction in relapse risk (HR,.74; 95% CI,.56 to.97; P =.03). There was a statistically nonsignificant trend toward higher NRM with a haplo/PTCy approach (HR, 1.65; 95% CI,.99 to 2.77; P =.06). Haplo/PTCy-based approaches are associated with lower incidences of cGVHD and relapse, with PFS and OS outcomes comparable with MSD/CNI-based approaches. There was a leaning toward higher NRM with a haplo/PTCy-based platform. These data show that haplo/PTCy allo-HCT in cHL results in survival comparable with MSD/CNI-based allo-HCT.

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