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Lymphoma

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

Bone Marrow Transplantation volume 52, pages 689–696 (2017)Cite this article

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Abstract

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.

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Acknowledgements

We thank all participating centers as well as our data manager Nicole Raus and Rachel Tipton, the SFGM-TC secretary. JG sends special thanks to Leila Moukthari for her most precious help updating our database and retrieving missing data.

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Authors and Affiliations

  1. CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Service des Maladies du Sang, Secteur Allogreffe de Cellules Souches Hématopoïétiques, Lille, France

    J Gauthier & I Yakoub-Agha

  2. UFR Médecine, Université de Lille, Lille, France

    J Gauthier & I Yakoub-Agha

  3. Department of Haematology, Humanitas Cancer Center, Rozzano, Italy

    L Castagna

  4. Agence Nationale de Biomédecine, Registre France Greffe de Moelle, Saint-Denis La Plaine, France

    F Garnier

  5. Department of Haematology, Nantes University Hospital, Nantes, France

    T Guillaume

  6. Department of Haematology, Saint-Louis Hospital, APHP, Paris, France

    G Socié & R Peffault de Latour

  7. Department of Haematology, Henri-Mondor Hospital, APHP, Paris, France

    S Maury

  8. Department of Haematology, Poitiers University Hospital, Poitiers, France

    N Maillard

  9. Department of Haematology and Cellular Therapy, Haut-Lévêque University Hospital, Bordeaux, France

    R Tabrizi

  10. Department of Haematology, Rennes University Hospital, Rennes, France

    T Marchand

  11. Department of Haematology, Percy Hospital, Clamart, France

    J Malfuson

  12. Department of Haematology, Caen University Hospital, Caen, France

    A Gac

  13. Department of Haematology and Cellular Therapy, Tours University Hospital, UMR CNRS, François Rabelais University, Tours, France

    E Gyan

  14. Department of Haematology, Angers University Hospital, Angers, France

    M Mercier

  15. Department of Haematology, Liège University Hospital, Liège, Belgium

    Y Béguin

  16. Department of Haematology, Montpellier University Hospital, Montpellier, France

    J Delage

  17. Department of Haematology, Limoges University Hospital, Limoges, France

    P Turlure

  18. Department of Haematology, Necker Hospital, APHP, Paris, France

    A Marçais

  19. Department of Haematology, Pitié Salpêtrière Hospital, APHP, Paris, France

    S Nguyen

  20. Department of Haematology, Saint-Antoine Hospital, APHP, Paris, France

    R Dulery

  21. Department of Haematology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France

    J Bay

  22. Department of Haematology, Toulouse University Hospital, Toulouse, France

    A Huynh

  23. Department of Haematology, Besançon University Hospital, Besançon, France

    E Daguindau

  24. Department of Haematology, Loire Cancer Institute, Saint Priest en Jarez, France

    J Cornillon

  25. Department of Haematology, Grenoble University Hospital, Grenoble, France

    C Régny

  26. Department of Haematology, Lyon University Hospital, Lyon, France

    M Michallet

  27. Department of Haematology, Paoli Calmette Institute, Aix Marseille University, Centre de Recherche en Cancérologie, Inserm, CNRS UMR, Marseille, France

    D Blaise

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  1. J Gauthier
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  6. S Maury
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  8. R Tabrizi
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  14. Y Béguin
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  15. J Delage
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  16. P Turlure
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  17. A Marçais
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  18. S Nguyen
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  19. R Dulery
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  20. J Bay
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  26. R Peffault de Latour
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  27. I Yakoub-Agha
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  28. D Blaise
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Correspondence to D Blaise.

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Gauthier, J., Castagna, L., Garnier, F. et al. 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. Bone Marrow Transplant 52, 689–696 (2017). https://doi.org/10.1038/bmt.2016.349

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