title: Reduced-intensity and non-myeloablative allogeneic stem cell transplantation from alternative HLA-mismatched donors for Hodgkin lymphoma: a study by the French Society of Bone Marrow Transplantation and Cellular Therapy.
abstract: Allogeneic stem cell transplantation (allo-SCT) following a non-myeloablative (NMA) or reduced-intensity conditioning (RIC) is considered a valid approach to treat patients with refractory/relapsed Hodgkin lymphoma (HL). When an HLA-matched donor is lacking a graft from a familial haploidentical (HAPLO) donor, a mismatched unrelated donor (MMUD) or cord blood (CB) might be considered. In this retrospective study, we compared the outcome of patients with HL undergoing a RIC or NMA allo-SCT from HAPLO, MMUD or CB. Ninety-eight patients were included. Median follow-up was 31 months for the whole cohort. All patients in the HAPLO group (N=34) received a T-cell replete allo-SCT after a NMA (FLU-CY-TBI, N=31, 91%) or a RIC (N=3, 9%) followed by post-transplant cyclophosphamide. After adjustment for significant covariates, MMUD and CB were associated with significantly lower GvHD-free relapse-free survival (GRFS; hazard ratio (HR)=2.02, P=0.03 and HR=2.43, P=0.009, respectively) compared with HAPLO donors. In conclusion, higher GRFS was observed in Hodgkin lymphoma patients receiving a RIC or NMA allo-SCT with post-transplant cyclophosphamide from HAPLO donors. Our findings suggest they should be favoured over MMUD and CB in this setting.
authors.affiliation: CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Service des Maladies du Sang, Secteur Allogreffe de Cellules Souches Hématopoïétiques, Lille, France.|UFR Médecine, Université de Lille, Lille, France.
authors.forename: J
authors.initials: J
authors.lastname: Gauthier
authors.affiliation: Department of Haematology, Humanitas Cancer Center, Rozzano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Castagna
authors.affiliation: Agence Nationale de Biomédecine, Registre France Greffe de Moelle, Saint-Denis La Plaine, France.
authors.forename: F
authors.initials: F
authors.lastname: Garnier
authors.affiliation: Department of Haematology, Nantes University Hospital, Nantes, France.
authors.forename: T
authors.initials: T
authors.lastname: Guillaume
authors.affiliation: Department of Haematology, Saint-Louis Hospital, APHP, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.affiliation: Department of Haematology, Henri-Mondor Hospital, APHP, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Maury
authors.affiliation: Department of Haematology, Poitiers University Hospital, Poitiers, France.
authors.forename: N
authors.initials: N
authors.lastname: Maillard
authors.affiliation: Department of Haematology and Cellular Therapy, Haut-Lévêque University Hospital, Bordeaux, France.
authors.forename: R
authors.initials: R
authors.lastname: Tabrizi
authors.affiliation: Department of Haematology, Rennes University Hospital, Rennes, France.
authors.forename: T
authors.initials: T
authors.lastname: Marchand
authors.affiliation: Department of Haematology, Percy Hospital, Clamart, France.
authors.forename: J
authors.initials: J
authors.lastname: Malfuson
authors.affiliation: Department of Haematology, Caen University Hospital, Caen, France.
authors.forename: A
authors.initials: A
authors.lastname: Gac
authors.affiliation: Department of Haematology and Cellular Therapy, Tours University Hospital, UMR CNRS, François Rabelais University, Tours, France.
authors.forename: E
authors.initials: E
authors.lastname: Gyan
authors.affiliation: Department of Haematology, Angers University Hospital, Angers, France.
authors.forename: M
authors.initials: M
authors.lastname: Mercier
authors.affiliation: Department of Haematology, Liège University Hospital, Liège, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Béguin
authors.affiliation: Department of Haematology, Montpellier University Hospital, Montpellier, France.
authors.forename: J
authors.initials: J
authors.lastname: Delage
authors.affiliation: Department of Haematology, Limoges University Hospital, Limoges, France.
authors.forename: P
authors.initials: P
authors.lastname: Turlure
authors.affiliation: Department of Haematology, Necker Hospital, APHP, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Marçais
authors.affiliation: Department of Haematology, Pitié Salpêtrière Hospital, APHP, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Nguyen
authors.affiliation: Department of Haematology, Saint-Antoine Hospital, APHP, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Dulery
authors.affiliation: Department of Haematology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Bay
authors.affiliation: Department of Haematology, Toulouse University Hospital, Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Huynh
authors.affiliation: Department of Haematology, Besançon University Hospital, Besançon, France.
authors.forename: E
authors.initials: E
authors.lastname: Daguindau
authors.affiliation: Department of Haematology, Loire Cancer Institute, Saint Priest en Jarez, France.
authors.forename: J
authors.initials: J
authors.lastname: Cornillon
authors.affiliation: Department of Haematology, Grenoble University Hospital, Grenoble, France.
authors.forename: C
authors.initials: C
authors.lastname: Régny
authors.affiliation: Department of Haematology, Lyon University Hospital, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.affiliation: Department of Haematology, Saint-Louis Hospital, APHP, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Peffault de Latour
authors.affiliation: CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Service des Maladies du Sang, Secteur Allogreffe de Cellules Souches Hématopoïétiques, Lille, France.|UFR Médecine, Université de Lille, Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: Department of Haematology, Paoli Calmette Institute, Aix Marseille University, Centre de Recherche en Cancérologie, Inserm, CNRS UMR, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Blaise
mesh_terms: D000328:Adult; D036101:Cord Blood Stem Cell Transplantation; D003520:Cyclophosphamide / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease; D006680:HLA Antigens; D006648:Histocompatibility; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods* / Q000592:standards; D019172:Transplantation Conditioning / Q000379:methods*; D000075442:Transplantation, Haploidentical; D014184:Transplantation, Homologous; D061349:Unrelated Donors / Q000600:supply & distribution
chemical_list: D006680:HLA Antigens; D003520:Cyclophosphamide