title: Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin's lymphoma.
abstract: Twenty-six patients with advanced Hodgkin's disease received a related HLA haploidentical unmanipulated BMT, following a non-myeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose post-transplantation CY (PT-CY), mycophenolate and a calcineurin inhibitor. All patients had received a previous autograft, and 65% had active disease at the time of BMT. Sustained engraftment of donor cells occurred in 25 patients (96%), with a median time to neutrophil recovery (>0.5 × 10(9)/L) and platelet recovery (>20 × 10(9)/L) of +18 and +23 days from BMT. The incidence of grade II-IV acute GVHD and of chronic GVHD was 24% and 8%, respectively. With a median follow-up of 24 months (range 18-44) 21 patients are alive, 20 disease free. The cumulative incidence of TRM and relapse was 4% and 31%, respectively. The actuarial 3-year survival is 77%, the actuarial 3-year PFS is 63%. In conclusion, we confirm that high-dose PT-CY is effective as prophylaxis of GVHD after HLA haploidentical BMT, can prevent rejection and does not appear to eliminate the allogeneic graft versus lymphoma effect.
authors.affiliation: Divisione Ematologia e Trapianto di Midollo Osseo, IRCCS San Martino-IST, Genova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Raiola
authors.affiliation: Divisione Ematologia e Trapianto di Midollo Osseo, IRCCS San Martino-IST, Genova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Dominietto
authors.affiliation: Divisione Ematologia e Trapianto di Midollo Osseo, IRCCS San Martino-IST, Genova, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Varaldo
authors.affiliation: Divisione Ematologia e Trapianto di Midollo Osseo, IRCCS San Martino-IST, Genova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ghiso
authors.affiliation: Divisione Ematologia e Trapianto di Midollo Osseo, IRCCS San Martino-IST, Genova, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Galaverna
authors.affiliation: Bone Marrow Transplantation Unit, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bramanti
authors.affiliation: Bone Marrow Transplantation Unit, Milano, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Todisco
authors.affiliation: Bone Marrow Transplantation Unit, Milano, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Sarina
authors.affiliation: Statistical Unit, Istituto Clinico Humanitas, Milano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Bone Marrow Transplantation Unit, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ibatici
authors.affiliation: Bone Marrow Transplantation Unit, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Santoro
authors.affiliation: Divisione Ematologia e Trapianto di Midollo Osseo, IRCCS San Martino-IST, Genova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Clavio
authors.affiliation: Divisione Ematologia e Trapianto di Midollo Osseo, IRCCS San Martino-IST, Genova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.affiliation: Bone Marrow Transplantation Unit, Milano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Castagna
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005838:Genotype; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult