Haploidentical related donor compared to HLA-identical donor transplantation for chemosensitive Hodgkin lymphoma patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-11-24

AUTHORS

Luca Castagna, Alessandro Busca, Stefania Bramanti, Maria Raiola Anna, Michele Malagola, Fabio Ciceri, William Arcese, Daniele Vallisa, Francesca Patriarca, Giorgina Specchia, Roberto Raimondi, Raynier Devillier, Sabine Furst, Laura Giordano, Barbara Sarina, Jacopo Mariotti, Attilio Olivieri, Reda Bouabdallah, Carmelo Carlo-Stella, Alessandro Rambaldi, Armando Santoro, Paolo Corradini, Andrea Bacigalupo, Francesca Bonifazi, Didier Blaise

ABSTRACT

BackgroundAllogeneic stem cell transplantation from haploidentical donor using an unmanipulated graft and post-transplantation cyclophosphamide (PT-Cy) is growing. Haploidentical transplantation with PT-Cy showed a major activity in Hodgkin lymphoma (HL), reducing the relapse incidence. The most important predictive factor of survival and toxicity was disease status before transplantation, which was better in patients with well controlled disease.MethodsWe included 198 HL in complete (CR) or partial remission (PR) before transplantation. Sixty-five patients were transplanted from haploidentical donor and 133 from a HLA identical donor (both sibling and unrelated donors). Survival analysis was defined according to the EBMT criteria. Survival curves were generated by using Kaplan-Meier method and differences between groups were compared by the log rank test or by the log rank test for trend when appropriated.ResultsThe PFS, OS, and RI were significantly better in patients in CR compared to PR (55% vs 29% p = 0.001, 74% vs 55% p = 0.03, 27% vs 55% p < 0.001, respectively). The 2-year PFS was significantly better for HAPLO than HLA-id (63% vs 37%, p = 0.03), without difference in OS. The 1-year NRM was not different. The 2-year relapse incidence (RI) was lower in the HAPLO group (24% vs 44%, p = 0.008). Patients in CR receiving haplo HSCT showed higher 2-year PFS and lower 2-year RI than those allografted with HLA-id donor (75% vs 47%, p < 0.001 and 11% vs 34%, p < 0.001, respectively). In multivariate analysis, donor type and disease status before transplantation were independent predictors of PFS as well as they predict the risk of relapse. Disease status at transplantation and age were independently associated to OS.ConclusionsNonetheless this is a retrospective study, limiting the wide applicability of results, data from this analysis suggest that HLA mismatch can induce a strong graft versus lymphoma effect leading to an enhanced PFS. More... »

PAGES

1140

Journal

TITLE

BMC Cancer

ISSUE

1

VOLUME

20

Author Affiliations

  • Humanitas Cancer Center, BMT Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, Rozzano, MI, Italy
  • Hematology Department Azienda ospedaliera Universitaria S Giovanni Battista, Torino, Italy
  • Division of Hematology and Hematopoietic Stem Cell Transplantation Unit, Ospedale Policlinico San Martino-IRCCS per l’Oncologia, Genoa, Italy
  • Department of Clinical and Experimental Sciences, Unit of Blood Diseases and Stem Cells Transplantation, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
  • Hematology and BMT Unit, Ospedale S Raffaele, Milan, Italy
  • Department of Hematology, Stem Cell Transplant Unit, Rome Transplant Network, “Tor Vergata” University Hospital, Rome, Italy
  • Hematology Department, Ospedale Gda Saliceto di Piacenza, Piacenza, Italy
  • Hematology, Department of Medical Area, University of Udine, Udine, Italy
  • Hematology Section, DAP University of Bari, Bari, Italy
  • Hematology Department, S. Bortolo Hospital, Vicenza, Italy
  • Hematology Department, Transplantation and Cellular Therapy Unit, Institut Paoli-Calmettes, Marseille, France
  • Humanitas Cancer Center, Statistical Unit, Humanitas Research Hospital, Rozzano, Italy
  • Department of Hematology, Medical School, University of Ancona, Ancona, Italy
  • Hematology Department, Lymphoma Program, Institut Paoli-Calmettes, Marseille, France
  • Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
  • Hematology and Bone Marrow Transplant Unit, Fondazione IRCCS Istituto Nazionale Tumori and University of Milano, Milan, Italy
  • Istituto di Ematologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
  • Institute of Hematology and Medical Oncology, L and A Seràgnoli, St Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s12885-020-07602-w

    DOI

    http://dx.doi.org/10.1186/s12885-020-07602-w

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1132893452

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33234127


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