Allogeneic transplantation for relapsed and refractory Hodgkin lymphoma: long-term outcomes and graft-versus-host disease-free/relapse-free survival

Leuk Lymphoma. 2019 Jan;60(1):101-109. doi: 10.1080/10428194.2018.1459607. Epub 2018 May 1.

Abstract

This monocentric retrospective study included 70 consecutive relapsed/refractory Hodgkin lymphoma (RR-HL) patients receiving reduced-intensity allogeneic stem cell transplantation (alloSCT). We evaluated overall and progression-free survival (OS, PFS), graft-versus host disease/relapse-free survival (GFRS), and chronic GVHD-free OS (cGVHD-free OS) defined as OS without moderate-to-severe cGVHD. Patients had a median age of 33 years (range, 18-60 years), 23% had refractory disease (SD/PD). Donors were HLA identical (39%), unrelated (30%), or haploidentical (31%). Median follow-up was 6.2 years. Five-year OS was 59% and PFS was 49%. NRM was 16% at 1 year. 44% of patients had cGVHD, and 14% moderate-to-severe cGVHD at last follow-up. GFRS and cGVHD-free OS were 26 and 48% at 5 years. In multivariate analysis, resistant disease at alloSCT impacted survival and GFRS. In conclusion, disease response before alloSCT impacts survival and GFRS. GVHD outcomes may help comparing the long-term effects of the new salvage treatments that bridge patients to alloSCT.

Keywords: GFRS; Hodgkin lymphoma; allogeneic transplantation; cGVHD-free survival; long-term survival.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Drug Resistance, Neoplasm
  • Female
  • Follow-Up Studies
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / epidemiology*
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Progression-Free Survival
  • Quality of Life
  • Retrospective Studies
  • Salvage Therapy / adverse effects
  • Salvage Therapy / methods*
  • Severity of Illness Index
  • Survival Analysis
  • Time Factors
  • Transplantation Conditioning / methods
  • Transplantation, Homologous / adverse effects
  • Young Adult