title: Double umbilical cord blood transplant is effective therapy for relapsed or refractory Hodgkin lymphoma.
abstract: A sub-group of patients with Hodgkin Lymphoma (HL) who relapse after autologous stem cell transplant can achieve long-term disease-free-survival after allogeneic stem cell transplant (alloSCT). There is limited information regarding the tolerability and efficacy of double umbilical cord blood transplant (dUCBT) for relapsed/refractory HL. We analyzed 27 consecutive, heavily pre-treated patients receiving dUCBT for relapsed/refractory HL at two centers from 2003-2014. The majority of patients relapsed <6 months after autologous stem cell transplant. A total of 15 patients received myeloablative (most commonly melphalan, fludarabine, thiotepa and anti-thymocyte globulin [ATG]) and 12 non-myeloablative conditioning regimens (fludarabine, cyclophosphamide, 200cGy total body irradiation +/- ATG). All patients engrafted; median time to neutrophil and platelet engraftment was 17 and 37 days, respectively. Overall response rate was 68%; 58% achieved complete remission. Median progression-free survival (PFS) was 12.2 months; median overall survival was 27 months. Cumulative incidences of relapse and of non-relapse mortality at 5 years were 30% and 37.9%, respectively; 5-year PFS was 31.3% (95%CI 10.1-52.5). There was a trend toward inferior PFS in patients with lymph node size ≥2 cm at the time of alloSCT (p = 0.07) and toward inferior survival in patients with chemorefractory disease pre-alloSCT (p = 0.12). dUCBT is feasible in patients with heavily pre-treated HL and can achieve long-term disease-free survival in approximately 30% of patients.
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Philip A
authors.initials: PA
authors.lastname: Thompson
authors.affiliation: b Department of Clinical Haematology and Bone Marrow Transplant Service , Royal Melbourne Hospital , Parkville , Australia ;
authors.forename: Travis
authors.initials: T
authors.lastname: Perera
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: David
authors.initials: D
authors.lastname: Marin
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Betul
authors.initials: B
authors.lastname: Oran
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Muzaffar
authors.initials: M
authors.lastname: Qazilbash
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Nina
authors.initials: N
authors.lastname: Shah
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Simrit
authors.initials: S
authors.lastname: Parmar
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Katayoun
authors.initials: K
authors.lastname: Rezvani
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Amanda
authors.initials: A
authors.lastname: Olson
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Partow
authors.initials: P
authors.lastname: Kebriaei
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rondon
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Amin
authors.initials: A
authors.lastname: Alousi
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Stefan
authors.initials: S
authors.lastname: Ciurea
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.affiliation: b Department of Clinical Haematology and Bone Marrow Transplant Service , Royal Melbourne Hospital , Parkville , Australia ;
authors.forename: Ashish
authors.initials: A
authors.lastname: Bajel
authors.affiliation: b Department of Clinical Haematology and Bone Marrow Transplant Service , Royal Melbourne Hospital , Parkville , Australia ;|c The Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Parkville , Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Szer
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Shpall
authors.affiliation: b Department of Clinical Haematology and Bone Marrow Transplant Service , Royal Melbourne Hospital , Parkville , Australia ;|c The Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Parkville , Australia.
authors.forename: David
authors.initials: D
authors.lastname: Ritchie
authors.affiliation: a Department of Stem Cell Transplantation and Cellular Therapy , University of Texas M.D. Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Chitra M
authors.initials: CM
authors.lastname: Hosing
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D019008:Drug Resistance, Neoplasm; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006689:Hodgkin Disease / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012008:Recurrence; D019233:Retreatment; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D055815:Young Adult
keywords: Clinical results; graft-versus-host disease; lymphoma and Hodgkin disease