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Conditioning Regimens

Reduced-intensity allogeneic stem cell transplantation in relapsed and refractory Hodgkin's disease: low transplant-related mortality and impact of intensity of conditioning regimen

Bone Marrow Transplantation volume 35, pages 943–951 (2005)Cite this article

Summary:

A total of 40 patients with relapsed/refractory Hodgkin's disease (HD) underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT) from an HLA-identical sibling (n=20) or a matched unrelated donor (n=20). The median age was 31 years (range 18–58). Disease status at allo-SCT was refractory relapse (n=14) or sensitive relapse (n=26). The conditioning regimens were fludarabine-cyclophosphamide±antithymocyte globulin (n=14), a less intensive regimen, and fludarabine-melphalan (FM) (n=26), a more intensive one. The two groups had similar prognostic factors. The median time to neutrophil recovery (ie absolute neutrophil count ⩾500/μl) was 12 days (range 10–24). The median time to platelet recovery (ie platelet count ⩾20 000/μl) was 17 days (range 7–132). Day 100 and cumulative (18-month) transplant-related mortalities (TRMs) were 5 and 22%. Twenty-four patients (60%) are alive (14 in complete remission or complete remission, unconfirmed/uncertain) with a median follow-up of 13 months (4–78). In all, 16 patients expired (TRM n=8, disease progression n=8). FM patients had better overall survival (73 vs 39% at 18 months; P=0.03), and a trend towards better progression-free survival (37 vs 21% at 18 months; P=0.2). RIC allo-SCT is feasible in relapsed/refractory HD patients with a low TRM. The intensity of the preparative regimen affects survival.

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Acknowledgements

We are indebted to Muriel Giese for her secretarial assistance.

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Authors and Affiliations

  1. Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    P Anderlini, R Saliba, S Acholonu, G-J Okoroji, M Donato, S Giralt, B Andersson, N T Ueno, I Khouri, M De Lima, C Hosing, A Cohen & R E Champlin

  2. Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    C Ippoliti

  3. Department of Lymphoma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    J Romaguera, M A Rodriguez, B Pro, L Fayad, A Goy & A Younes

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  1. P Anderlini
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Correspondence to P Anderlini.

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Anderlini, P., Saliba, R., Acholonu, S. et al. Reduced-intensity allogeneic stem cell transplantation in relapsed and refractory Hodgkin's disease: low transplant-related mortality and impact of intensity of conditioning regimen. Bone Marrow Transplant 35, 943–951 (2005). https://doi.org/10.1038/sj.bmt.1704942

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