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

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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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 (2020). https://doi.org/10.1038/s41409-020-01075-y

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