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Clinical Trial
. 2008 Feb;93(2):257-64.
doi: 10.3324/haematol.11828. Epub 2008 Jan 26.

Fludarabine-melphalan as a preparative regimen for reduced-intensity conditioning allogeneic stem cell transplantation in relapsed and refractory Hodgkin's lymphoma: the updated M.D. Anderson Cancer Center experience (V体育安卓版)

Paolo Anderlini  1 , Rima Saliba, Sandra Acholonu, Sergio A Giralt, Borje Andersson, Naoto T Ueno, Chitra Hosing, Issa F Khouri, Daniel Couriel, Marcos de Lima, Muzaffar H Qazilbash, Barbara Pro, Jorge Romaguera, Luis Fayad, Frederick Hagemeister, Anas Younes, Mark F Munsell, Richard E Champlin
Affiliations
Clinical Trial

VSports - Fludarabine-melphalan as a preparative regimen for reduced-intensity conditioning allogeneic stem cell transplantation in relapsed and refractory Hodgkin's lymphoma: the updated M.D. Anderson Cancer Center experience

Paolo Anderlini et al. Haematologica. 2008 Feb.

Abstract

Background: The role of reduced-intensity conditioning allogeneic stem cell transplantation in relapsed/refractory Hodgkin's lymphoma remains poorly defined VSports手机版. We here present an update of our single-center experience with fludarabine-melphalan as a preparative regimen. .

Design and methods: Fifty-eight patients with relapsed/refractory Hodgkin's lymphoma underwent RIC and allogeneic stem cell transplantation from a matched related donor (MRD; n=25) or a matched unrelated donor (MUD; n=33). Forty-eight (83%) had undergone prior autologous stem cell transplantation. Disease status at transplant was refractory relapse (n=28) or sensitive relapse (n=30). V体育安卓版.

Results: Cumulative day 100 and 2-year transplant-related mortality rates were 7% and 15%, respectively (day 100 transplant-related mortality MRD vs. MUD 8% vs. 6%, p=ns; 2-year MRD vs. MUD 13% vs. 16%, p=ns). The cumulative incidence of acute (grade II-IV) graft-versus-host disease in the first 100 days was 28% (MRD vs. MUD 12% vs. 39%, p=0. 04). The cumulative incidence of chronic graft-versus-host disease at any time was 73% (MRD vs. MUD 57% vs. 85%, p=0. 006). Projected 2-year overall and progression-free survival rates are 64% (49-76%) and 32% (20-45%), with 2-year disease progression/relapse at 55% (43-70%) V体育ios版. There was no statistically significant differences in overall survival progression-free survival, and disease progression/relapse between MRD and MUD transplants. There was a trend for the response status pretransplant to have a favorable impact on progression-free survival (p=0. 07) and disease progression/relapse (p=0. 049), but not on overall survival (p=0. 4) .

Conclusions: Fludarabine-melphalan as a preparative regimen for reduced-intensity conditioning allogeneic stem cell transplantation in progression-free survival Hodgkin's lymphoma is associated with a significant reduction in transplant-related mortality, with comparable results in MRD and MUD allografts VSports最新版本. Optimizing pretransplant response status may improve patients' outcome. .

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Figures

Figure 1
Figure 1
Kaplan-Meier estimates for overall survival (OS) and progression-free survival (PFS) (left) and cumulative incidence of disease progression (right) for the whole group.
Figure 2
Figure 2
Kaplan-Meier estimates for progression-free survival (PFS) according to donor type.
Figure 3
Figure 3
Kaplan-Meier estimates for progression-free survival (PFS) according to response status pretransplant. CR: complete remission; CRU: complete remission, unconfirmed/uncertain (see text for response definitions).
See this image and copyright information in PMC

References

    1. Connors JM. Evolving approaches to primary treatment of Hodgkin’s lymphoma. In: Berliner M, Lee SJ, Linenberger M, Vogelsang GB, editors. Hematology 2005; 47th American Society of Hematology Annual Meeting and Exposition Education Program Book; 2005. pp. 239–244. - V体育安卓版 - PubMed
    1. Moskowitz CH. Perry MC: Am Soc Clin Oncol Ed Book. 2004. Controversies in the management of relapsed and primary refractory Hodgkin’s lymphoma; pp. 360–367.
    1. Bartlett NL. Therapies for relapsed Hodgkin lymphoma: Transplant and non transplant approaches including immunotherapy. In: Berliner M, Lee SJ, Linenberger M, Vogelsang GB, editors. Hematology 2005; 47th American Society of Hematology Annual Meeting and Exposition Education Program Book; 2005. pp. 245–251. - PubMed
    1. Brusamolino E, Carella AM. Treatment of relapsed and refractory Hodgkin’s lymphoma: facts and perspectives. Haematologica. 2007;92:6–10. - PubMed (V体育ios版)
    1. Linch DC, Goldstone AH. High-dose therapy for Hodgkin’s disease. Br J Haematology. 1999;107:685–690. - "VSports" PubMed

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