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Tandem autologous-reduced intensity allogeneic stem cell transplantation in high-risk relapsed Hodgkin lymphoma: a retrospective study of the Lymphoma Working Party—EBMT

Bone Marrow Transplantation volume 56, pages 655–663 (2021)Cite this article

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Abstract

Autologous hematopoietic stem cell transplantation (ASCT) is curative for a proportion of patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL). However, there is a small group of patients with high-risk of relapse after ASCT that might benefit from other approaches. We conducted a retrospective analysis on 126 patients treated with tandem ASCT-reduced intensity conditioning (RIC)-allogeneic-SCT and reported to the EBMT registry to analyze the efficacy and safety of this approach. Patients were included if they had received an ASCT followed by a planned RIC-SCT in <6 months without relapse between the procedures. The median time between diagnosis and ASCT was 16 months (2–174). The median number of lines prior to ASCT was two (33% of the patients received >3 lines). Forty-one percent were transplanted with active disease. The median follow-up was 44 months (6–130). Three-year-progression-free survival (PFS), overall survival (OS), incidence of relapse (IR), and non-relapse mortality (NRM) after the tandem were 53% (45–64), 73% (65–81), 34% (24–42), and 13% (8–21), respectively. This is the largest series analyzing the efficacy and safety of a tandem approach in R/R HL. The low NRM and IR with promising PFS and OS suggest that this might be an effective procedure for a high-risk population.

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Fig. 1: CI of relapse, NRM, PFS and OS of all series.
Fig. 2: PFS and OS according to the interval from diagnosis to ASCT.
Fig. 3: PFS and OS according to number of lines prior to ASCT.
Fig. 4: CI of acute and chronic GVHD.

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Acknowledgements

LB and AS performed the research. LB, HF, IK, DB, NF, LC, EF, PC, NM, PB, ED, MG, PC, MH, MM, AT, DC, and SN contributed to clinical data. LB, AB, SM, and AS contributed to the analysis and data interpretation. AB served as the statistician. All authors contributed to review, provided their comments on this manuscript and approval the final version.

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Authors and Affiliations

  1. Hematology Department, Son Espases University Hospital, IdISBa, Palma de Mallorca, Spain

    Leyre Bento

  2. Lymphoma Working Party, EBMT, Paris, France

    Ariane Boumendil, Hervé Finel & Irma Khvedelidze

  3. Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  4. CHU Lapeyronie, Montpellier, France

    Nathalie Fegueux

  5. Istituto Clinico Humanitas, Rozzano Milano, Italy

    Luca Castagna

  6. CHU Bordeaux, Pessac, France

    Edouard Forcade

  7. CHU Nantes, Nantes, France

    Patrice Chevallier

  8. Az. Ospedaliera S. Croce e Carle, Cuneo, Italy

    Nicola Mordini

  9. Hôpital St. Louis, Paris, France

    Pauline Brice

  10. Hopital Jean Minjoz, Besançon, France

    Eric Deconinck

  11. University Medical Center Schleswig-Holstein, Kiel, Germany

    Martin Gramatzki

  12. Istituto Nazionale dei Tumori, Milano, Italy

    Paolo Corradini

  13. CHRU Angers, Angers, France

    Mathilde Hunault

  14. Ospedale La Maddalena, Palermo, Italy

    Maurizio Musso

  15. Nottingham University, Nottingham, UK

    Anna Tsoulkani

  16. Hospital Clínico Salamanca, Salamanca, Spain

    Dolores Caballero

  17. Azienda Ospedaliera Universitaria San Martino, Genova, Italy

    Sandro Nati

  18. St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK

    Silvia Montoto

  19. Institut Català d’Oncologia (ICO)-Hospitalet, IDIBELL, Universitat de Barcelona, Barcelona, Spain

    Anna Sureda

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  1. Leyre Bento
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on behalf of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

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Correspondence to Leyre Bento.

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This study has been presented as an oral presentation at 46st Annual Meeting of the European Society for Blood and Marrow Transplantation on the 26th March 2019 and at 24th European Haematology Association Congress on the 16th June 2019.

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Bento, L., Boumendil, A., Finel, H. et al. Tandem autologous-reduced intensity allogeneic stem cell transplantation in high-risk relapsed Hodgkin lymphoma: a retrospective study of the Lymphoma Working Party—EBMT. Bone Marrow Transplant 56, 655–663 (2021). https://doi.org/10.1038/s41409-020-01075-y

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