Reduced-intensity conditioning for allogeneic haematopoietic stem cell transplantation in relapsed and refractory Hodgkin lymphoma: impact of alemtuzumab and donor lymphocyte infusions on long-term outcomes

British Journal of Haematology
Karl S PeggsUK and Spanish Collaborative Groups

Abstract

The introduction of reduced-intensity conditioning (RIC) has enabled the role of allogeneic transplantation to be re-evaluated in Hodgkin lymphoma (HL). While T-cell depletion reduces graft-versus-host disease (GvHD), it potentially abrogates graft-versus-tumour activity and increases infective complications. We compared the results in 67 sibling donor transplantations following RIC in multiply relapsed patients from two national phase II studies conditioned with fludarabine/melphalan. One used cyclosporine/alemtuzumab (MF-A, n = 31), the other used cyclosporine/methotrexate (MF, n = 36) as GvHD prophylaxis. There was a small excess of chemorefractory cases in the MF cohort (P = NS). MF-A resulted in significantly lower incidences of non-relapse mortality, acute and chronic GvHD, but no significant excess of relapse/progression. Post donor lymphocyte infusion (DLI) disease responses occurred in 8/14 (57%) and 6/11 (55%) patients in the MF-A and MF groups, respectively. Current progression-free survival (CPFS) was superior with MF-A (univariate analysis), with durable responses to DLI contributing to the favourable outcome (43% vs. 25%, P = 0.0356). Disease status at transplantation significantly influenced overall survival (P =...Continue Reading

References

Apr 1, 1994·Journal of Clinical Pathology·J R SalisburyA B Nethersell
Dec 1, 1993·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J E AndersonJ E Sanders
Feb 1, 1996·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J L GajewskiM M Horowitz
Apr 1, 1996·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Noel MilpiedAnthony H Goldstone
Nov 24, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·D L PorterJoseph H Antin
Jul 25, 2000·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·L J Johnston, S J Horning
Dec 4, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·G AkpekR J Jones
Jun 25, 2002·Annals of Oncology : Official Journal of the European Society for Medical Oncology·A Sureda, N Schmitz
Oct 18, 2002·Blood·José A Pérez-SimónSpanish and United Kingdom Collaborative Groups for Nonmyeloablative Transplantation
Jul 13, 2005·European Journal of Haematology. Supplementum·N Schmitz, A Sureda
Jan 31, 2006·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Iván AlvarezJorge Sierra
Jun 2, 2006·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Paolo Anderlini, Richard E Champlin
Aug 10, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Frédéric BaronBrenda M Sandmaier

Citations

Aug 24, 2010·Current Hematologic Malignancy Reports·Rachel B SalitSteven Z Pavletic
Dec 17, 2009·Hematology·John Kuruvilla
May 4, 2013·Immunotherapy·Najla El-JurdiMohamed A Kharfan-Dabaja
Jun 21, 2011·Advances in Hematology·S E Richardson, C McNamara
Jun 28, 2011·Expert Opinion on Biological Therapy·Xavier Poiré, Koen van Besien
Jan 29, 2011·Expert Opinion on Biological Therapy·Claire Roddie, Karl S Peggs
Nov 30, 2013·Hematology/oncology Clinics of North America·Mark Hertzberg
Oct 9, 2013·Experimental Hematology·Adam JonaArpad Illés
May 28, 2008·Best Practice & Research. Clinical Haematology·A John Barrett, Katarina Le Blanc
May 28, 2008·Best Practice & Research. Clinical Haematology·Edwin P Alyea
Sep 23, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·L FarinaP Corradini
Aug 20, 2008·British Journal of Haematology·Karl S PeggsA Sureda
Dec 16, 2010·British Journal of Haematology·P CorradiniL Farina
Jun 9, 2010·The Journal of Pathology·Donatella AldinucciAntonino Carbone
Oct 15, 2013·British Journal of Haematology·Graham P CollinsKarl S Peggs
Mar 17, 2015·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Miguel-Angel PeralesPaul A Carpenter
Jun 21, 2008·Experimental Hematology·Jorge CastilloPeter Quesenberry
Oct 29, 2010·Advances in Hematology·Evgeny KlyuchnikovAxel Rolf Zander
Apr 1, 2015·British Journal of Haematology·Toby A Eyre, Graham P Collins
May 4, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Ron RamAjay K Gopal
Oct 26, 2011·Pediatric Hematology and Oncology·Javier El-Bietar, Catherine Bollard
Feb 18, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Luca CastagnaDidier Blaise
Apr 27, 2013·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Mohamed A Kharfan-DabajaMehdi Hamadani
Dec 14, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Erica D WarlickJeffrey S Miller
Oct 14, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Mehdi HamadaniSteven M Devine
Mar 17, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Luca CastagnaArmando Santoro
Aug 28, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Ulas D BayraktarStefan O Ciurea
Jan 26, 2011·Blood·John KuruvillaMichael Crump
Jul 28, 2012·Lancet·William Townsend, David C Linch
Feb 2, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Karl S PeggsStephen Mackinnon
Jan 13, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Marcel P DevettenPaolo Anderlini
Dec 1, 2011·Therapeutic Advances in Hematology·Alison Rager, David L Porter
Nov 14, 2013·British Journal of Hospital Medicine·Toby A EyreGraham P Collins
Dec 12, 2018·British Journal of Haematology·Gottfried von Keudell, Anas Younes
Mar 16, 2019·Expert Review of Hematology·Parastoo B DahiHillard M Lazarus
Oct 1, 2008·Expert Review of Hematology·Dennis A EichenauerGerman Hodgkin Study Group
Jun 1, 2009·Expert Review of Hematology·David Sibon, Pauline Brice
Sep 3, 2013·Expert Review of Hematology·Alessandro IsidoriGiuseppe Visani
Jul 29, 2016·Current Opinion in Oncology·Philippe Lewalle, Sebastian Wittnebel
Sep 1, 2015·Journal of Leukocyte Biology·Frederik Wein, Ralf Küppers
Nov 28, 2017·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Thomas NeumannWilliam Krüger
Feb 29, 2020·Therapeutic Advances in Hematology·Theodoros P VassilakopoulosMaria K Angelopoulou

Related Concepts

Fludarabine
MabCambath
Monoclonal Antibodies
Tumor Antibodies
Antineoplastic Agents
Graft-vs-Host Disease
Hodgkin Lymphoma, Lymphocyte Depletion
Lymphocyte Depletion
Medphalan
Methotrexate, (DL)-Isomer

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