Superiority of reduced-intensity allogeneic transplantation over conventional treatment for relapse of Hodgkin's lymphoma following autologous stem cell transplantation.
Thomson, Kirsty J Peggs, Karl S Smith, P Cavet, James Hunter, Ann Parker, Anne Pettengell, Ruth Milligan, Donald W Morris, Emma C Goldstone, Anthony H
Thomson, Kirsty J
Peggs, Karl S
Smith, P
Cavet, James
Hunter, Ann
Parker, Anne
Pettengell, Ruth
Milligan, Donald W
Morris, Emma C
Goldstone, Anthony H
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Abstract
This study compares outcome of reduced-intensity conditioned transplant (RIT) with outcome of conventional non-transplant therapy in patients with Hodgkin's lymphoma relapsing following autograft. There were 72 patients in two groups who had relapsed, and received salvage therapy with chemotherapy+/-radiotherapy. One group (n=38) then underwent alemtuzumab-containing RIT. The second group-historical controls (n=34), relapsing before the advent of RIT-had no further high-dose therapy. This group was required to respond to salvage therapy and live for over 12 months post-relapse, demonstrating potential eligibility for RIT, had this been available. Overall survival (OS) from diagnosis was superior following RIT (48% at 10 years versus 15%; P=0.0014), as was survival from autograft (65% at 5 years versus 15%; P< or =0.0001). For the RIT group, OS at 5 years from allograft was 51%, and in chemoresponsive patients was 58%, with current progression-free survival of 42%. Responses were seen in 8 of 15 patients receiving donor lymphocyte infusions (DLI) for relapse/progression, with durable remission in five patients at median follow-up from DLI of 45 months (28-55). These data demonstrate the potential efficacy of RIT in heavily pre-treated patients whose outlook with conventional therapy is dismal, and provide evidence of a clinically relevant graft-versus-lymphoma effect.
Description
Date
2008-05
Publisher
Collections
Keywords
Hodgkin Lymphoma
Stem Cell Transplantation
Stem Cell Transplantation
Type
Article
Citation
Superiority of reduced-intensity allogeneic transplantation over conventional treatment for relapse of Hodgkin's lymphoma following autologous stem cell transplantation. 2008, 41 (9):765-70 Bone Marrow Transplant.