title: Impact of disease status and stem cell source on the results of reduced intensity conditioning transplant for Hodgkin's lymphoma: a retrospective study from the French Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC).
abstract: The role of reduced intensity allogeneic stem cell transplantation for the treatment of relapsed/refractory Hodgkin's lymphoma remains controversial. We retrospectively analyzed 191 patients who underwent reduced intensity allogeneic stem cell transplantation between 1998 and 2008 for relapsed or refractory Hodgkin's lymphoma and whose data were reported to the French registry. The median follow-up was 36 months. The estimated 3-year overall survival rate, progression-free survival rate, cumulative incidence of relapse and cumulative incidence of non-relapse mortality were 63%, 39%, 46%, and 16%, respectively. There was no difference in outcome between patients in complete response and in partial response at the time of transplantation with regards to overall survival (70% versus 74%, no significant difference) and progression-free survival (51% versus 42%, no significant difference). Patients with chemoresistant disease had a shorter overall survival (39% at 3 years; P=0.0003) and progression-free survival (18% at 3 years; P=0.001) than patients in complete remission. The use of umbilical cord blood as the source of stem cells was associated with a poor outcome with an increased risk of death with a hazard ratio of 3.49 (95% confidence interval: 1.26 to 9.63; P=0.016). The use of peripheral blood was associated with a better outcome for patients who where alive 1 year after transplantation with a hazard ratio of 0.38 (95% confidence interval: 0.17 to 0.83; P=0.016). Disease status at transplantation remains the most important risk factor for outcome. Our data suggest that the use of peripheral blood should be preferred whereas umbilical cord blood should be used with caution.
authors.affiliation: Service d’Hématologie, Hôpital Universitaire Necker, Université René Descartes, Institut Imagine, Paris, France. ambroise.marcais@nck.aphp.fr
authors.forename: Ambroise
authors.initials: A
authors.lastname: Marcais
authors.forename: Raphael
authors.initials: R
authors.lastname: Porcher
authors.forename: Marie
authors.initials: M
authors.lastname: Robin
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michalet
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.forename: Reza
authors.initials: R
authors.lastname: Tabrizi
authors.forename: Laurence
authors.initials: L
authors.lastname: Clement
authors.forename: Patrice
authors.initials: P
authors.lastname: Ceballos
authors.forename: Etienne
authors.initials: E
authors.lastname: Daguindau
authors.forename: Karin
authors.initials: K
authors.lastname: Bilger
authors.forename: Nathalie
authors.initials: N
authors.lastname: Dhedin
authors.forename: Simona
authors.initials: S
authors.lastname: Lapusan
authors.forename: Jacques-Olivier
authors.initials: JO
authors.lastname: Bay
authors.forename: Cécile
authors.initials: C
authors.lastname: Pautas
authors.forename: Frederic
authors.initials: F
authors.lastname: Garban
authors.forename: Norbert
authors.initials: N
authors.lastname: Ifrah
authors.forename: Gaelle
authors.initials: G
authors.lastname: Guillerm
authors.forename: Nathalie
authors.initials: N
authors.lastname: Contentin
authors.forename: Jean-Henri
authors.initials: JH
authors.lastname: Bourhis
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub Agha
authors.forename: Marc
authors.initials: M
authors.lastname: Bernard
authors.forename: Jérôme
authors.initials: J
authors.lastname: Cornillon
authors.forename: Noel
authors.initials: N
authors.lastname: Milpied
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012955:Societies, Medical; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous; D055815:Young Adult
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