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Changes in patients population and characteristics of hematopoietic stem cell transplantation for relapsed/refractory Hodgkin lymphoma: an analysis of the Lymphoma Working Party of the EBMT

Bone Marrow Transplantation volume 55, pages 2170–2179 (2020)Cite this article

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Abstract

Indications for autologous (auto-HCT) and allogeneic transplantation (allo-HCT) in relapsed/refractory Hodgkin lymphoma (rrHL) have been long established. The expectation is that long-term outcomes have significantly improved over time with increased experience in these procedures. The objective of this study was to assess whether this is the case and to identify further areas of improvement. A total of 13,639 adult patients receiving an auto-HCT or allo-HCT for rrHL were reported to the European Society for Blood and Marrow Transplantation (EBMT) over a 25-year period. Regarding auto-HCT, recipients are younger, interval between diagnosis and transplant shorter, peripheral blood has become the universal stem cell source and the use of total body irradiation is almost non-existent in recent years. Allo-HCT is currently mostly used as a second transplant; recipients are younger, fitter and less frequently, chemorefractory. Reduced intensity conditioning protocols have vastly replaced myeloablative protocols. Increasing numbers of haplo-HCT have been reported. Both in auto-HCT and allo-HCT, NRM, PFS and OS have significantly improved but relapse remains the main cause of treatment failure. A better selection of patients and improvements in the supportive care has resulted in a reduction in the NRM. Relapse after HCT remains unchanged and further research is needed.

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Fig. 1: Haematopoietic stem cell transplantation activity over time.
Fig. 2: Evolution of outcomes for auto-HCT over time.
Fig. 3: Evolution of outcomes for allo-HCT over time.
Fig. 4: Cumulative incidences of acute and chronic graft versus host disease over time.

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Author notes

  1. These authors contributed equally: Anna Sureda, Sonja Genadieva Stavrik

Authors and Affiliations

  1. Clinical Hematology Department, Institut Català d’Oncologia-Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain

    Anna Sureda

  2. University Hematology Clinic, Medical faculty, Skopje, Republic of North Macedonia

    Sonja Genadieva Stavrik

  3. EBMT, Lymphoma Working party, Paris, France

    Ariane Boumendil, Hervé Finel & Irma Khvedelidze

  4. Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany

    Sascha Dietricht & Peter Dreger

  5. Department of Clinical Haematology, AP-HP, Necker Hospital, Paris, France

    Olivier Hermine

  6. Department of Hematology, University College London Hospital, London, UK

    Chara Kyriakou

  7. Bone Marrow Transplant Unit, University Hospital Bristol, Bristol, UK

    Stephen Robinson

  8. Department of Medicine A, Hematology and Oncology, University Hospital Muenster, Muenster, Germany

    Norbert Schmitz

  9. Department of Hematology, Academische Ziekenhuis, Maastricht, Netherlands

    Harry C. Schouten

  10. Department of Stem Cell Transplantation, Fundeni Clinical Institute, Bucharest, Romania

    Alina Tanase

  11. Department of Haemato-Oncology, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK

    Silvia Montoto

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Correspondence to Anna Sureda.

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Sureda, A., Genadieva Stavrik, S., Boumendil, A. et al. Changes in patients population and characteristics of hematopoietic stem cell transplantation for relapsed/refractory Hodgkin lymphoma: an analysis of the Lymphoma Working Party of the EBMT. Bone Marrow Transplant 55, 2170–2179 (2020). https://doi.org/10.1038/s41409-020-0929-y

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