title: Myeloablative versus reduced intensity allogeneic stem cell transplantation for relapsed/refractory Hodgkin's lymphoma in recent years: a retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation.
abstract: To evaluate long-term outcome of myeloablative allogeneic stem cell transplantation (allo-SCT) (MAC) versus reduced-intensity allo-SCT (RIC) in patients with relapsed/refractory Hodgkin's lymphoma (HL) in recent years.
  
  
  
  A total of 312 patients (63 MAC and 249 RIC) with relapsed/refractory HL who received allo-SCT between 2006 and 2010 and were reported to the EBMT Database were included in the study.
  
  
  
  With a median follow-up for alive patients of 56 (26-73) months, there were no significant differences in non-relapse mortality (NRM) between MAC and RIC. Relapse rate (RR) was somewhat lower in the MAC group (41% versus 52% at 24 months, P = 0.16). This lower RR translated into a marginal improvement in event-free survival (EFS) for the MAC group (48% versus 36% at 24 months, P = 0.09) with no significant differences in overall survival (73% for MAC and 62% for RIC at 24 months, P = 0.13). Multivariate analysis after adjusting for disease status at the time of allo-SCT showed that the use of MAC was of borderline statistical significance for predicting a lower RR and EFS [HR 0.7, 95% CI (0.5-1.0), P = 0.1] and [HR 0.7, 95% CI (0.5-1.0), P = 0.07], respectively, after allo-SCT.
  
  
  
  With modern transplant practices, the NRM associated with MAC for HL has strongly decreased, resulting into non-significant improvement of EFS because of a somewhat better disease control compared with RIC transplants. The intensity of conditioning regimens should be considered when designing individual allo-SCT strategies or clinical trials in patients with relapsed/refractory HL.
authors.affiliation: BMT Unit, University Hematology Clinic, Medical Faculty-Skopje, Skopje, Macedonia.
authors.forename: S
authors.initials: S
authors.lastname: Genadieva-Stavrik
authors.affiliation: EBMT Lymphoma Working Party, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Boumendil
authors.affiliation: EBMT Lymphoma Working Party, Paris, France.|Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Dreger
authors.affiliation: Hematology, University College London Hospitals NHS Trust, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Peggs
authors.affiliation: Department of Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Briones
authors.affiliation: IRCCS Istituto Nazionale dei Tumori, University of Milano, Milano.
authors.forename: P
authors.initials: P
authors.lastname: Corradini
authors.affiliation: Hematology, Ospedale S. Martino, Genova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.affiliation: Haematology, Hôpital Saint-Louis, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.affiliation: Hematology, Orsola-Malpighi University Hospital, Bologna.
authors.forename: F
authors.initials: F
authors.lastname: Bonifazi
authors.affiliation: EBMT Lymphoma Working Party, Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Finel
authors.affiliation: Hematology, Ospedale Santa Maria della Misericordia, Perugia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Velardi
authors.affiliation: Hematology, The Royal Marsden Hospital, London and Surrey, UK.
authors.forename: M
authors.initials: M
authors.lastname: Potter
authors.affiliation: Department of Hematology, Azienda Ospedaliera Univerzitaria Citta della Salute e della Sciencia, Torino.
authors.forename: B
authors.initials: B
authors.lastname: Bruno
authors.affiliation: Department of Oncology and Hematology, Humanitas Cancer Center, Humanitas Clinical and Research Center, Milano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Castagna
authors.affiliation: Centre for Clinical Haematology, Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham.
authors.forename: R
authors.initials: R
authors.lastname: Malladi
authors.affiliation: Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: N
authors.initials: N
authors.lastname: Russell
authors.affiliation: Department of Hematology, Institut Català d'Oncologia-Hospital Duran I Reynals, Barcelona, Spain asureda@iconcologia.net.
authors.forename: A
authors.initials: A
authors.lastname: Sureda
mesh_terms: D000328:Adult; D000368:Aged; D001853:Bone Marrow; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006689:Hodgkin Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: allogeneic stem cell transplantation; conditioning regimen; relapsed/refractory Hodgkin's lymphoma