Reduced intensity conditioning allogeneic stem cell transplantation for Hodgkin's lymphoma: identification of prognostic factors predicting outcome.

2.50
Hdl Handle:
http://hdl.handle.net/10541/69768
Title:
Reduced intensity conditioning allogeneic stem cell transplantation for Hodgkin's lymphoma: identification of prognostic factors predicting outcome.
Authors:
Robinson, Stephen P; Sureda, Anna; Canals, Carmen; Russell, Nigel; Caballero, Dolores; Bacigalupo, Andrea; Iriondo, Arturo; Cook, Gordon; Pettitt, Andrew; Socie, Gerard; Bonifazi, Francesca; Bosi, Alberto; Michallet, Mauricette; Liakopoulou, Effie F; Maertens, Johan; Passweg, Jakob; Clark, Fiona; Martino, Rodrigo; Schmitz, Norbert
Abstract:
BACKGROUND: The role of reduced intensity conditioning allogeneic stem transplantation (RICalloSCT) in the management of patients with Hodgkin's lymphoma remains controversial. DESIGN AND METHODS: To further define its role we have conducted a retrospective analysis of 285 patients with HL who underwent a RICalloSCT in order to identify prognostic factors that predict outcome. Eighty percent of patients had undergone a prior autologous stem cell transplantation and 25% had refractory disease at transplant. RESULTS: Non-relapse mortality was associated with chemorefractory disease, poor performance status, age >45 and transplantation before 2002. For patients with no risk factors the 3-year non-relapse mortality rate was 12.5% compared to 46.2% for patients with 2 or more risk factors. The use of an unrelated donor had no adverse effect on the non-relapse mortality. Acute graft versus host disease (aGVHD) grades II-IV developed in 30% and chronic GVHD in 42%. The development of cGVHD was associated with a lower relapse rate. The disease progression rate at one and five years was 41% and 58.7% respectively and was associated with chemorefractory disease and extent of prior therapy. Donor lymphocyte infusions were administered to 64 patients for active disease of whom 32% showed a clinical response. Eight out of 18 patients receiving donor lymphocyte infusions alone had clinical responses. Progression-free and overall survival were both associated with performance status and disease status at transplant. Patients with neither risk factor had a 3-year PFS and overall survival of 42% and 56% respectively compared to 8% and 25% for patients with one or more risk factors. Relapse within six months of a prior autologous transplant was associated with a higher relapse rate and a lower progression-free. CONCLUSIONS: This analysis identifies important clinical parameters that may be useful in predicting the outcome of RICaIICalloSCT in Hodgkin's lymphoma.
Affiliation:
BMT Unit, Bristol Children's Hospital, UK. stephen.robinson@ubht.swest.nhs.uk
Citation:
Reduced intensity conditioning allogeneic stem cell transplantation for Hodgkin's lymphoma: identification of prognostic factors predicting outcome. 2009, 94 (2):230-8 Haematologica
Journal:
Haematologica
Issue Date:
Feb-2009
URI:
http://hdl.handle.net/10541/69768
DOI:
10.3324/haematol.13441
PubMed ID:
19066328
Type:
Article
Language:
en
ISSN:
1592-8721
Appears in Collections:
All Christie Publications ; Haematology

Full metadata record

DC FieldValue Language
dc.contributor.authorRobinson, Stephen P-
dc.contributor.authorSureda, Anna-
dc.contributor.authorCanals, Carmen-
dc.contributor.authorRussell, Nigel-
dc.contributor.authorCaballero, Dolores-
dc.contributor.authorBacigalupo, Andrea-
dc.contributor.authorIriondo, Arturo-
dc.contributor.authorCook, Gordon-
dc.contributor.authorPettitt, Andrew-
dc.contributor.authorSocie, Gerard-
dc.contributor.authorBonifazi, Francesca-
dc.contributor.authorBosi, Alberto-
dc.contributor.authorMichallet, Mauricette-
dc.contributor.authorLiakopoulou, Effie F-
dc.contributor.authorMaertens, Johan-
dc.contributor.authorPassweg, Jakob-
dc.contributor.authorClark, Fiona-
dc.contributor.authorMartino, Rodrigo-
dc.contributor.authorSchmitz, Norbert-
dc.date.accessioned2009-06-05T10:17:20Z-
dc.date.available2009-06-05T10:17:20Z-
dc.date.issued2009-02-
dc.identifier.citationReduced intensity conditioning allogeneic stem cell transplantation for Hodgkin's lymphoma: identification of prognostic factors predicting outcome. 2009, 94 (2):230-8 Haematologicaen
dc.identifier.issn1592-8721-
dc.identifier.pmid19066328-
dc.identifier.doi10.3324/haematol.13441-
dc.identifier.urihttp://hdl.handle.net/10541/69768-
dc.description.abstractBACKGROUND: The role of reduced intensity conditioning allogeneic stem transplantation (RICalloSCT) in the management of patients with Hodgkin's lymphoma remains controversial. DESIGN AND METHODS: To further define its role we have conducted a retrospective analysis of 285 patients with HL who underwent a RICalloSCT in order to identify prognostic factors that predict outcome. Eighty percent of patients had undergone a prior autologous stem cell transplantation and 25% had refractory disease at transplant. RESULTS: Non-relapse mortality was associated with chemorefractory disease, poor performance status, age >45 and transplantation before 2002. For patients with no risk factors the 3-year non-relapse mortality rate was 12.5% compared to 46.2% for patients with 2 or more risk factors. The use of an unrelated donor had no adverse effect on the non-relapse mortality. Acute graft versus host disease (aGVHD) grades II-IV developed in 30% and chronic GVHD in 42%. The development of cGVHD was associated with a lower relapse rate. The disease progression rate at one and five years was 41% and 58.7% respectively and was associated with chemorefractory disease and extent of prior therapy. Donor lymphocyte infusions were administered to 64 patients for active disease of whom 32% showed a clinical response. Eight out of 18 patients receiving donor lymphocyte infusions alone had clinical responses. Progression-free and overall survival were both associated with performance status and disease status at transplant. Patients with neither risk factor had a 3-year PFS and overall survival of 42% and 56% respectively compared to 8% and 25% for patients with one or more risk factors. Relapse within six months of a prior autologous transplant was associated with a higher relapse rate and a lower progression-free. CONCLUSIONS: This analysis identifies important clinical parameters that may be useful in predicting the outcome of RICaIICalloSCT in Hodgkin's lymphoma.en
dc.language.isoenen
dc.subjectHodgkin's Lymphomaen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshFemale-
dc.subject.meshHematopoietic Stem Cell Transplantation-
dc.subject.meshHodgkin Disease-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPrognosis-
dc.subject.meshRetrospective Studies-
dc.subject.meshTransplantation Conditioning-
dc.subject.meshTransplantation, Homologous-
dc.subject.meshTreatment Outcome-
dc.subject.meshYoung Adult-
dc.titleReduced intensity conditioning allogeneic stem cell transplantation for Hodgkin's lymphoma: identification of prognostic factors predicting outcome.en
dc.typeArticleen
dc.contributor.departmentBMT Unit, Bristol Children's Hospital, UK. stephen.robinson@ubht.swest.nhs.uken
dc.identifier.journalHaematologicaen

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