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Allogeneic stem cell transplantation after reduced intensity conditioning in patients with relapsed or refractory Hodgkin's lymphoma. Results of the HDR-ALLO study - a prospective clinical trial by the Grupo Español de Linfomas/ Trasplante de Médula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation
Sureda, Anna (Institut d'Investigació Biomèdica Sant Pau)
Canals, Carme (European Society for Blood and Marrow Transplantation (Barcelona))
Arranz, Reyes (Hospital de la Princesa (Madrid))
Caballero, Dolores (Hospital Clínico Universitario (Salamanca))
Ribera, Josep Maria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Brune, Mats (Sahlgrenska University Hospital. Hematology Section)
Passweg, Jacob (Hopitaux Universitaires de Geneve. Departement Medecine Interne)
Martino, Rodrigo (Institut d'Investigació Biomèdica Sant Pau)
Valcárcel, David (Institut d'Investigació Biomèdica Sant Pau)
Besalduch, Joan (Hospital Son Dureta (Palma de Mallorca))
Duarte, Rafael (Institut Català d'Oncologia)
León, Angel (Hospital de Jerez de la Frontera)
Pascual, Maria Jesús (Hospital Carlos Haya (Málaga))
García-Noblejas, Ana (Hospital de la Princesa (Madrid))
López Corral, Lucia (Hospital Clínico Universitario (Salamanca))
Xicoy, Bianca (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Sierra Gil, Jordi (Institut d'Investigació Biomèdica Sant Pau)
Schmitz, Norbert (Asklepios Klinik St. Georg. Hematology/Oncology Department)

Fecha: 2012
Resumen: Background: Although Hodgkin's lymphoma is a highly curable disease with modern chemotherapy protocols, some patients are primary refractory or relapse after first-line chemotherapy or even after high-dose therapy and autologous stem cell transplantation. We investigated the potential role of allogeneic stem cell transplantation in this setting. Design and Methods: In this phase II study 92 patients with relapsed Hodgkin's lymphoma and an HLA-identical sibling, a matched unrelated donor or a one antigen mismatched, unrelated donor were treated with salvage chemotherapy followed by reduced intensity allogeneic transplantation. Fourteen patients showed refractory disease and died from progressive lymphoma with a median overall survival after trial entry of 10 months (range, 6-17). Seventy-eight patients proceeded to allo-graft (unrelated donors, n=23). Fifty were allografted in complete or partial remission and 28 in stable disease. Fludarabine (150 mg/m iv) and melphalan (140 mg/m iv) were used as the conditioning regimen. Anti-thymocyte globulin was additionally used as graft-versus-host-disease prophylaxis for recipients of grafts from unrelated donors. Results: The non-relapse mortality rate was 8% at 100 days and 15% at 1 year. Relapse was the major cause of failure. The progression-free survival rate was 47% at 1 year and 18% at 4 years from trial entry. For the allografted population, the progression-free survival rate was 48% at 1 year and 24% at 4 years. Chronic graft-versus-host disease was associated with a lower incidence of relapse. Patients allografted in complete remission had a significantly better outcome. The overall survival rate was 71% at 1 year and 43% at 4 years. Conclusions: Allogeneic stem cell transplantation can result in long-term progression-free survival in heavily pre-treated patients with Hodgkin's lymphoma. The reduced intensity conditioning approach significantly reduced non-relapse mortality; the high relapse rate represents the major remaining challenge in this setting. The HDR-Allo trial was registered in the European Clinical Trials Database (EUDRACT, https://eudract. ema. europa. eu/) with number 02-0036.
Derechos: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. Creative Commons
Lengua: Anglès.
Documento: article ; recerca ; publishedVersion
Materia: Allogeneic stem cell transplantation ; Reduced intensity conditioning ; Hodgkin's lymphoma relapsed ; Refractory
Publicado en: Haematologica, Vol. 97, Núm. 2 (january 2012) , p. 310-317, ISSN 1592-8721

DOI: 10.3324/haematol.2011.045757
PMID: 21993674


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El registro aparece en las colecciones:
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació Biomèdica Sant Pau
Artículos > Artículos de investigación
Artículos > Artículos publicados

 Registro creado el 2019-05-20, última modificación el 2020-04-19



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