TY - JOUR
T1 - Double umbilical cord blood transplant is effective therapy for relapsed or refractory Hodgkin lymphoma
AU - Thompson, Philip A.
AU - Perera, Travis
AU - Marin, David
AU - Oran, Betul
AU - Popat, Uday
AU - Qazilbash, Muzaffar
AU - Shah, Nina
AU - Parmar, Simrit
AU - Rezvani, Katayoun
AU - Olson, Amanda
AU - Kebriaei, Partow
AU - Anderlini, Paolo
AU - Rondon, Gabriela
AU - Alousi, Amin
AU - Ciurea, Stefan
AU - Champlin, Richard E.
AU - Bajel, Ashish
AU - Szer, Jeffrey
AU - Shpall, Elizabeth J.
AU - Ritchie, David
AU - Hosing, Chitra M.
N1 - Publisher Copyright:
© 2015 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2016/7/2
Y1 - 2016/7/2
N2 - A sub-group of patients with Hodgkin Lymphoma (HL) who relapse after autologous stem cell transplant can achieve long-term disease-free-survival after allogeneic stem cell transplant (alloSCT). There is limited information regarding the tolerability and efficacy of double umbilical cord blood transplant (dUCBT) for relapsed/refractory HL. We analyzed 27 consecutive, heavily pre-treated patients receiving dUCBT for relapsed/refractory HL at two centers from 2003–2014. The majority of patients relapsed <6 months after autologous stem cell transplant. A total of 15 patients received myeloablative (most commonly melphalan, fludarabine, thiotepa and anti-thymocyte globulin [ATG]) and 12 non-myeloablative conditioning regimens (fludarabine, cyclophosphamide, 200cGy total body irradiation +/- ATG). All patients engrafted; median time to neutrophil and platelet engraftment was 17 and 37 days, respectively. Overall response rate was 68%; 58% achieved complete remission. Median progression-free survival (PFS) was 12.2 months; median overall survival was 27 months. Cumulative incidences of relapse and of non-relapse mortality at 5 years were 30% and 37.9%, respectively; 5-year PFS was 31.3% (95%CI 10.1–52.5). There was a trend toward inferior PFS in patients with lymph node size ≥2 cm at the time of alloSCT (p = 0.07) and toward inferior survival in patients with chemorefractory disease pre-alloSCT (p = 0.12). dUCBT is feasible in patients with heavily pre-treated HL and can achieve long-term disease-free survival in approximately 30% of patients.
AB - A sub-group of patients with Hodgkin Lymphoma (HL) who relapse after autologous stem cell transplant can achieve long-term disease-free-survival after allogeneic stem cell transplant (alloSCT). There is limited information regarding the tolerability and efficacy of double umbilical cord blood transplant (dUCBT) for relapsed/refractory HL. We analyzed 27 consecutive, heavily pre-treated patients receiving dUCBT for relapsed/refractory HL at two centers from 2003–2014. The majority of patients relapsed <6 months after autologous stem cell transplant. A total of 15 patients received myeloablative (most commonly melphalan, fludarabine, thiotepa and anti-thymocyte globulin [ATG]) and 12 non-myeloablative conditioning regimens (fludarabine, cyclophosphamide, 200cGy total body irradiation +/- ATG). All patients engrafted; median time to neutrophil and platelet engraftment was 17 and 37 days, respectively. Overall response rate was 68%; 58% achieved complete remission. Median progression-free survival (PFS) was 12.2 months; median overall survival was 27 months. Cumulative incidences of relapse and of non-relapse mortality at 5 years were 30% and 37.9%, respectively; 5-year PFS was 31.3% (95%CI 10.1–52.5). There was a trend toward inferior PFS in patients with lymph node size ≥2 cm at the time of alloSCT (p = 0.07) and toward inferior survival in patients with chemorefractory disease pre-alloSCT (p = 0.12). dUCBT is feasible in patients with heavily pre-treated HL and can achieve long-term disease-free survival in approximately 30% of patients.
KW - Clinical results
KW - graft-versus-host disease
KW - lymphoma and Hodgkin disease
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UR - http://www.scopus.com/inward/citedby.url?scp=84951276869&partnerID=8YFLogxK
U2 - 10.3109/10428194.2015.1105370
DO - 10.3109/10428194.2015.1105370
M3 - Article
C2 - 26472485
AN - SCOPUS:84951276869
SN - 1042-8194
VL - 57
SP - 1607
EP - 1615
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 7
ER -