Reduced-intensity and non-myeloablative allogeneic stem cell transplantation from alternative HLA-mismatched donors for Hodgkin lymphoma: a study by the French Society of Bone Marrow Transplantation and Cellular Therapy.

Date publication

mai 2017

Journal

Bone marrow transplantation

Auteurs

Membres identifiés du Cancéropôle Est :
Dr DAGUINDAU Etienne

Tous les auteurs :
Gauthier J, Castagna L, Garnier F, Guillaume T, Socié G, Maury S, Maillard N, Tabrizi R, Marchand T, Malfuson J, Gac A, Gyan E, Mercier M, Béguin Y, Delage J, Turlure P, Marçais A, Nguyen S, Dulery R, Bay J, Huynh A, Daguindau E, Cornillon J, Régny C, Michallet M, Peffault de Latour R, Yakoub-Agha I, Blaise D

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/28067872

Résumé

Allogeneic stem cell transplantation (allo-SCT) following a non-myeloablative (NMA) or reduced-intensity conditioning (RIC) is considered a valid approach to treat patients with refractory/relapsed Hodgkin lymphoma (HL). When an HLA-matched donor is lacking a graft from a familial haploidentical (HAPLO) donor, a mismatched unrelated donor (MMUD) or cord blood (CB) might be considered. In this retrospective study, we compared the outcome of patients with HL undergoing a RIC or NMA allo-SCT from HAPLO, MMUD or CB. Ninety-eight patients were included. Median follow-up was 31 months for the whole cohort. All patients in the HAPLO group (N=34) received a T-cell replete allo-SCT after a NMA (FLU-CY-TBI, N=31, 91%) or a RIC (N=3, 9%) followed by post-transplant cyclophosphamide. After adjustment for significant covariates, MMUD and CB were associated with significantly lower GvHD-free relapse-free survival (GRFS; hazard ratio (HR)=2.02, P=0.03 and HR=2.43, P=0.009, respectively) compared with HAPLO donors. In conclusion, higher GRFS was observed in Hodgkin lymphoma patients receiving a RIC or NMA allo-SCT with post-transplant cyclophosphamide from HAPLO donors. Our findings suggest they should be favoured over MMUD and CB in this setting.

Mots clés

Adult, Cord Blood Stem Cell Transplantation, Cyclophosphamide, therapeutic use, Disease-Free Survival, Female, Follow-Up Studies, Graft vs Host Disease, HLA Antigens, Histocompatibility, Hodgkin Disease, mortality, Humans, Male, Retrospective Studies, Stem Cell Transplantation, methods, Transplantation Conditioning, methods, Transplantation, Haploidentical, Transplantation, Homologous, Unrelated Donors, supply & distribution

Référence

Bone Marrow Transplant.. 2017 May;52(5):689-696