Allogeneic haematopoietic stem-cell transplantation with reduced intensity conditioning for advanced stage Hodgkin's lymphoma in Sweden: high incidence of post transplant lymphoproliferative disorder.
Allogeneic transplantation after reduced intensity conditioning (allo-RIC) is a treatment option for patients with Hodgkin's lymphoma (HL) relapsing after autologous transplantation. In all, 23 adult patients with HL underwent allo-RIC in Sweden between 2000 and 2007. The median number of previous treatment lines was five and 20 patients (87%) were previously autografted. TRM at 100 days and at 1 year was 13 and 22% respectively. Acute GVHD grades II-IV developed in 7 out of 23 patients (30%) and chronic GVHD in 10 out of 20 patients at risk (50%). The OS and EFS at three years was 59 and 27%, respectively. Four patients (17%) developed post transplant lymphoproliferative disease (PTLD) after a median time of 55 days (range 38-95); two of these patients later died. The study confirmed that allo-RIC is feasible, but associated with a substantial relapse rate: only 20% of the patients were still alive 7 years after the transplant. A finding of high incidence of PTLD needs to be confirmed in a larger trial that includes patients with non-HL and CLL.
Department of Hematology and Coagulation, Sahlgrenska University Hospital, Göteborg, Sweden. jan-erik.j.johansson@vgregion.se
J E
JE
Johansson
M
M
Remberger
V Lj
VLj
Lazarevic
H
H
Hallböök
A
A
Wahlin
E
E
Kimby
G
G
Juliusson
H
H
Omar
H
H
Hägglund
D000328:Adult; D003625:Data Collection; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006689:Hodgkin Disease / Q000150:complications / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult