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Gutiérrez-García G, Martínez C, Boumendil A, Finel H, Malladi R, Afanasyev B, Tsoulkani A, Wilson KMO, Bloor A, Nikoloudis M, Richardson D, López-Corral L, Castagna L, Cornelissen J, Giltat A, Collin M, Fanin R, Bonifazi F, Robinson S, Montoto S, Peggs KS, Sureda A. Long-term outcome of patients receiving haematopoietic allogeneic stem cell transplantation as first transplant for high-risk Hodgkin lymphoma: a retrospective analysis from the Lymphoma Working Party-EBMT. Br J Haematol 2021; 196:1018-1030. [PMID: 34750806 DOI: 10.1111/bjh.17939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022]
Abstract
We analysed long-term outcome of patients receiving haematopoietic allogeneic stem cell transplantation (allo-HSCT) as a first transplant for high-risk Hodgkin lymphoma (HL). One hundred and ninety patients were included in this study, 63% of them had previously received brentuximab vedotin and/or checkpoint inhibitors. Seventy patients (37%) received an unrelated donor allo-HSCT, 99 (51%) had myeloablative conditioning (MAC) and 60% had in vivo T-cell/depleted grafts (TCD). The 100-day cumulative incidence (CI) of grade II-IV acute graft-versus-host disease (GVHD) was 25% and the 3-year CI of chronic GVHD was 38%. The 3-year CI of non-relapse mortality (NRM) and relapse rate were 21% and 38% respectively. After a median follow-up of 58 months, 3-year overall survival (OS) and progression-free survival (PFS) were 58% and 41% respectively. Multivariate analysis showed that, in comparison to reduced-intensity conditioning regimens with or without TCD, MAC using TCD had similar NRM and a lower risk of relapse leading to significantly better OS and PFS. MAC without TCD was associated with higher NRM and worse survival outcomes. These results suggest that in patients with high-risk HL and candidates of allo-HSCT, a MAC strategy with TCD might be the best option.
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Affiliation(s)
- G Gutiérrez-García
- Department of Haematology, Bone Marrow Transplantation Unit, Hospital Clinic of Barcelona, University of Barcelona, Institut de Recerca Biomèdica August Pi i Sunyer, Barcelona, Spain
| | - C Martínez
- Department of Haematology, Bone Marrow Transplantation Unit, Hospital Clinic of Barcelona, University of Barcelona, Institut de Recerca Biomèdica August Pi i Sunyer, Barcelona, Spain
| | | | - H Finel
- Lymphoma Working Party, EBMT, Paris, France
| | - R Malladi
- School of Cancer Sciences, University of Birmingham, Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | - B Afanasyev
- State Medical Pavlov University, St. Petersburg, Russia
| | | | | | - A Bloor
- Haematology and Transplant Unit, Christie Hospital NHS Foundation Trust and University of Manchester, Manchester, UK
| | - M Nikoloudis
- Haematology Department Heart of England NHS Trust, Birmingham, UK
| | - D Richardson
- Department of Haematology, Southampton General Hospital, Southampton, UK
| | | | - L Castagna
- Department of Haematology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - J Cornelissen
- Erasmus MC Cancer Institute University Medical Centre Rotterdam Department of Haematology, Rotterdam, Netherlands
| | - A Giltat
- Department of Haematology, Medical University Hospital, Angers, France
| | | | - R Fanin
- Department of Haematology and Cellular Therapy 'Carlo Melzi', S. Maria della Misericordia University Hospital, DAME, University of Udine, Udine, Italy
| | - F Bonifazi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - S Robinson
- Department of Haematology and Oncology, Bristol University Hospital, Bristol, UK
| | - S Montoto
- St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - K S Peggs
- Department of Haematology, University College London Cancer Institute, London, UK
| | - A Sureda
- Clinical Department of Haematology, Institut Català d'Oncologia-Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain
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Bazarbachi A, Boumendil A, Finel H, Mohty M, Castagna L, Blaise D, Peggs K, Afanasyev B, Diez-Martin J, Corradini P, Socié G, Robinson S, Gutiérrez-García G, Bonifazi F, Yakoub-Agha I, Gülbas Z, Bloor A, Delage J, Esquirol A, Malladi R, Scheid C, Ghesquières H, Montoto S, Dreger P, Sureda A. BRENTUXIMAB VEDOTIN FOR RELAPSED HODGKIN LYMPHOMA AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION: a RETROSPECTIVE STUDY OF THE EBMT LYMPHOMA WORKING PARTY. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A. Bazarbachi
- Department of internal medicine; American University of Beirut; Beirut Lebanon
| | - A. Boumendil
- EBMT LWP Paris Office; Hôpital Saint-Antoine; Paris France
| | - H. Finel
- EBMT LWP Paris Office; Hôpital Saint-Antoine; Paris France
| | - M. Mohty
- Service d'Hématologie et Thérapie Cellulaire; Hôpital Saint Antoine; Paris France
| | - L. Castagna
- Department of Hematology; Istituto Clinico Humanitas; Milan Italy
| | - D. Blaise
- Department of internal medicine; Institut Paoli Calmettes; Marseille France
| | - K. Peggs
- Department of internal medicine; University College London Hospital; London UK
| | - B. Afanasyev
- Department of internal medicine; First State Pavlov Medical University of St. Petersburg; St. Petersburg Russian Federation
| | - J. Diez-Martin
- Department of internal medicine; Hospital Gregorio Marañón; Madrid Spain
| | - P. Corradini
- IRCCS Istituto Nazionale dei Tumori; University of Milano; Milan Italy
| | - G. Socié
- Department of internal medicine; Hopital St. Louis; Paris France
| | - S. Robinson
- Department of internal medicine; University Hospital Bristol; Bristol UK
| | | | - F. Bonifazi
- S.Orsola-Malpighi Hospital; Bologna University; Bologna Italy
| | | | - Z. Gülbas
- Department of internal medicine; Anadolu Medical Center Hospital; Kocaeli Turkey
| | - A. Bloor
- Department of internal medicine; Christie NHS Trust Hospital; Manchester UK
| | - J. Delage
- Department of internal medicine; CHU Lapeyronie; Montpellier France
| | - A. Esquirol
- Department of internal medicine; Hospital Santa Creu i Sant Pau; Barcelona Spain
| | - R. Malladi
- Department of internal medicine; Queen Elizabeth Hospital; Birmingham UK
| | - C. Scheid
- Department of internal medicine; University of Cologne; Cologne Germany
| | - H. Ghesquières
- Department of internal medicine; Centre Hospitalier Lyon Sud; Lyon France
| | - S. Montoto
- Department of Haemato-oncology; St Bartholomew's Hospital; London UK
| | - P. Dreger
- Dept Medicine V; University of Heidelberg; Heidelberg Germany
| | - A. Sureda
- Department of Haematology; Institut Catala d'Oncologia, Hospital Duran I Reynals; Barcelona Spain
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Rosiñol L, Jiménez R, Rovira M, Martínez C, Fernández-Avilés F, Marín P, Suárez-Lledó M, Gutiérrez-García G, Fernández de Larrea C, Carreras E, Urbano-Ispizua A, Bladé J. Allogeneic hematopoietic SCT in multiple myeloma: long-term results from a single institution. Bone Marrow Transplant 2015; 50:658-62. [PMID: 25621810 DOI: 10.1038/bmt.2014.320] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 11/11/2014] [Accepted: 12/15/2014] [Indexed: 01/14/2023]
Abstract
The role of allogeneic hematopoietic SCT (allo-HCT) in multiple myeloma (MM) remains controversial. A total of 58 patients received an allo-HCT (25 of them with myeloablative conditioning-allo-MAC-and 33 with reduced-intensity conditioning-allo-RIC) at our institution over a 28-year period. The CR rate for allo-MAC was 36%. The incidence of grade III-IV acute GVHD (aGVHD) and chronic GVHD (cGVHD) was 28% and 39%, respectively The TRM at any time was 60% and the main causes of death were aGVHD or infectious complications not directly related to GVHD. The estimated PFS and OS at 15 years were 8% and 15%, respectively. The CR rate with allo-RIC was 45%. The incidence of grade III-IV aGVHD and cGVHD were 24% and 41%, respectively. The TRM at any time was 33% and was mainly related to aGVHD. The estimated PFS and OS at 5 years were 22% and 38%, respectively. Despite its high TRM, a proportion of patients with high-risk myeloma (early relapse and newly diagnosed ultrahigh risk) may obtain long-term disease control with allo-HCT. New approaches aimed at decreasing the incidence of aGVHD, and consequently to decrease the TRM, are needed.
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Affiliation(s)
- L Rosiñol
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain [3] Amyloid and Myeloma Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - R Jiménez
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Amyloid and Myeloma Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - M Rovira
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - C Martínez
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - F Fernández-Avilés
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - P Marín
- 1] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Hemostherapy and Hemostasis Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - M Suárez-Lledó
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - G Gutiérrez-García
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - C Fernández de Larrea
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Amyloid and Myeloma Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - E Carreras
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - A Urbano-Ispizua
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Bone Marrow Transplant Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain [3] Institut of Research Josep Carreras, Barcelona, Spain
| | - J Bladé
- 1] Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain [2] Amyloid and Myeloma Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
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