title: Improving outcomes after allogeneic hematopoietic cell transplantation for Hodgkin lymphoma in the brentuximab vedotin era.
abstract: Allogeneic hematopoietic cell transplantation (alloHCT) remains a valuable treatment alternative for relapsed/refractory (R/R) Hodgkin lymphoma (HL). Data on alloHCT outcomes in the era of new HL therapies are needed. We evaluated 72R/R HL patients who received reduced intensity conditioning alloHCT and compared the time periods 2009-2013 (n=20) with 2000-2008 (n=52). Grafts included HLA-matched sibling (35%), unrelated donor (8%) and umbilical cord blood (56%). In the recent period, patients more often received brentuximab vedotin (BV, 60% vs 2%), had fewer comorbidities (Sorror index 0: 60% vs 12%) and were in complete remission (50% vs 23%). Median follow-up was 4.4 years. Three-year PFS improved for patients treated between 2009 and 2013 (49%, 95% CI 26-68%) as compared with the earlier era (23%, 95% CI 13-35%, P=0.02). Overall survival (OS) at 3 years was 84% (95% CI 57-94%) vs 50% (95% CI 36-62%, P=0.01), reflecting lower non-relapse mortality and relapse rates. In multivariate analysis mortality was higher among those with chemoresistance (HR 3.83, 95% CI 1.38-10.57), while treatment during the recent era was associated with better OS (HR for period 2009-2013: 0.24, 95% CI 0.07-0.79) and PFS (HR 0.46, 95% CI 0.23-0.92). AlloHCT in patients with R/R HL is now a more effective treatment than previously.
authors.affiliation: Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA.
authors.forename: L
authors.initials: L
authors.lastname: Hegerova
authors.affiliation: Division of Biostatistics, University of Minnesota Medical Center, Minneapolis, MN, USA.|Blood and Marrow Transplantation Program, University of Minnesota Medical Center, Minneapolis, MN, USA.
authors.forename: Q
authors.initials: Q
authors.lastname: Cao
authors.affiliation: Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA.|Blood and Marrow Transplantation Program, University of Minnesota Medical Center, Minneapolis, MN, USA.
authors.forename: A
authors.initials: A
authors.lastname: Lazaryan
authors.affiliation: Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA.|Blood and Marrow Transplantation Program, University of Minnesota Medical Center, Minneapolis, MN, USA.
authors.forename: B L
authors.initials: BL
authors.lastname: McClune
authors.affiliation: Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA.|Blood and Marrow Transplantation Program, University of Minnesota Medical Center, Minneapolis, MN, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Weisdorf
authors.affiliation: Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA.|Blood and Marrow Transplantation Program, University of Minnesota Medical Center, Minneapolis, MN, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Brunstein
authors.affiliation: Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA.|Blood and Marrow Transplantation Program, University of Minnesota Medical Center, Minneapolis, MN, USA.
authors.forename: V
authors.identifier: http://orcid.org/0000-0002-9325-432X
authors.initials: V
authors.lastname: Bachanova
mesh_terms: D000293:Adolescent; D000328:Adult; D000079963:Brentuximab Vedotin; D002648:Child; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality / Q000592:standards / Q000639:trends; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy / Q000379:methods / Q000639:trends*; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods / Q000639:trends; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018796:Immunoconjugates; D000079963:Brentuximab Vedotin