title: Allogeneic transplantation improves the overall and progression-free survival of Hodgkin lymphoma patients relapsing after autologous transplantation: a retrospective study based on the time of HLA typing and donor availability.
abstract: Hodgkin lymphoma relapsing after autologous transplantation (autoSCT) has a dismal outcome. Allogeneic transplantation (alloSCT) using reduced intensity conditioning (RIC) is a salvage option, but its effectiveness is still unclear. To evaluate the role of RIC alloSCT, we designed a retrospective study based on the commitment of attending physicians to perform a salvage alloSCT; thus, only Hodgkin lymphoma patients having human leukocyte antigen-typing immediately after the failed autoSCT were included. Of 185 patients, 122 found an identical sibling (55%), a matched unrelated (32%) or a haploidentical sibling (13%) donor; 63 patients did not find any donor. Clinical features of both groups did not differ. Two-year progression-free (PFS) and overall survival (OS) were better in the donor group (39.3% vs 14.2%, and 66% vs 42%, respectively, P < .001) with a median follow-up of 48 months. In multivariable analysis, having a donor was significant for better PFS and OS (P < .001). Patients allografted in complete remission showed a better PFS and OS. This is the largest study comparing RIC alloSCT versus conventional treatment after a failed autoSCT, indicating a survival benefit for patients having a donor.
authors.affiliation: Hematology Department, Istituto Clinico Humanitas, Milano, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sarina
authors.forename: Luca
authors.initials: L
authors.lastname: Castagna
authors.forename: Lucia
authors.initials: L
authors.lastname: Farina
authors.forename: Francesca
authors.initials: F
authors.lastname: Patriarca
authors.forename: Fabio
authors.initials: F
authors.lastname: Benedetti
authors.forename: Angelo M
authors.initials: AM
authors.lastname: Carella
authors.forename: Michele
authors.initials: M
authors.lastname: Falda
authors.forename: Stefano
authors.initials: S
authors.lastname: Guidi
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bonini
authors.forename: Samantha
authors.initials: S
authors.lastname: Ferrari
authors.forename: Michele
authors.initials: M
authors.lastname: Malagola
authors.forename: Enrico
authors.initials: E
authors.lastname: Morello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Milone
authors.forename: Benedetto
authors.initials: B
authors.lastname: Bruno
authors.forename: Nicola
authors.initials: N
authors.lastname: Mordini
authors.forename: Simonetta
authors.initials: S
authors.lastname: Viviani
authors.forename: Alessandro
authors.initials: A
authors.lastname: Levis
authors.forename: Laura
authors.initials: L
authors.lastname: Giordano
authors.forename: Armando
authors.initials: A
authors.lastname: Santoro
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006689:Hodgkin Disease / Q000628:therapy*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome