title: Reduced intensity allogeneic hematopoietic cell transplantation can induce durable remission in heavily pretreated relapsed Hodgkin lymphoma.
abstract: Hodgkin lymphoma (HL) can be aggressive and intractable in some cases. Patients who relapse after autologous HCT (auto-HCT) have limited treatment options. City of Hope reports our experience in the use of reduced intensity allogeneic hematopoietic cell transplantation (allo-HCT) in 24 heavily pretreated patients with relapsed HL, between January 2003 and December 2008. The median number of prior therapies was 5; 20/24 patients had prior auto-HCT. The conditioning regimen for all patients was fludarabine and melphalan. With a median follow-up for living patients of 39.0 months, at 2 years the overall survival (OS) was 60% (95% CI 42, 72) and the progression-free survival was 27% (95% CI 22, 32). Non-relapse mortality was 13.1% (95% CI 5.1, 31.4) at 2 years. The incidence of grade II-IV aGVHD was 45.8% and 8.3% for grade III-IV. Allo-HCT in heavily pretreated relapsed Hodgkin lymphoma is feasible, tolerable, and can induce durable clinical remissions.
authors.affiliation: Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA 91010, USA. rchen@coh.org
authors.forename: Robert
authors.initials: R
authors.lastname: Chen
authors.forename: Joycelynne M
authors.initials: JM
authors.lastname: Palmer
authors.forename: Leslie
authors.initials: L
authors.lastname: Popplewell
authors.forename: Jessica
authors.initials: J
authors.lastname: Shen
authors.forename: Eileen
authors.initials: E
authors.lastname: Smith
authors.forename: Maria
authors.initials: M
authors.lastname: Delioukina
authors.forename: Neil
authors.initials: N
authors.lastname: Kogut
authors.forename: Joseph
authors.initials: J
authors.lastname: Rosenthal
authors.forename: Stephen
authors.initials: S
authors.lastname: Forman
authors.forename: Auayporn
authors.initials: A
authors.lastname: Nademanee
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006689:Hodgkin Disease / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use; D012008:Recurrence; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D019653:Myeloablative Agonists; D014740:Vidarabine; C024352:fludarabine; D008558:Melphalan