Myeloablative versus reduced intensity allogeneic stem cell transplantation for relapsed/refractory Hodgkin's lymphoma in recent years: a retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation.

S Genadieva-Stavrik, A. Boumendil, P. Dreger, Karl Peggs, Javier Briones, P Corradini, A Bacigalupo, G Socié, F. Bonifazi, H. Finel, A. Velardi, M. Potter, B. Bruno, L Castagna, R Malladi, N. Russell, A. Sureda

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Abstract

BACKGROUND: To evaluate long-term outcome of myeloablative allogeneic stem cell transplantation (allo-SCT) (MAC) versus reduced-intensity allo-SCT (RIC) in patients with relapsed/refractory Hodgkin's lymphoma (HL) in recent years.PATIENTS AND METHODS: A total of 312 patients (63 MAC and 249 RIC) with relapsed/refractory HL who received allo-SCT between 2006 and 2010 and were reported to the EBMT Database were included in the study.RESULTS: With a median follow-up for alive patients of 56 (26-73) months, there were no significant differences in non-relapse mortality (NRM) between MAC and RIC. Relapse rate (RR) was somewhat lower in the MAC group (41% versus 52% at 24 months, P = 0.16). This lower RR translated into a marginal improvement in event-free survival (EFS) for the MAC group (48% versus 36% at 24 months, P = 0.09) with no significant differences in overall survival (73% for MAC and 62% for RIC at 24 months, P = 0.13). Multivariate analysis after adjusting for disease status at the time of allo-SCT showed that the use of MAC was of borderline statistical significance for predicting a lower RR and EFS [HR 0.7, 95% CI (0.5-1.0), P = 0.1] and [HR 0.7, 95% CI (0.5-1.0), P = 0.07], respectively, after allo-SCT.CONCLUSIONS: With modern transplant practices, the NRM associated with MAC for HL has strongly decreased, resulting into non-significant improvement of EFS because of a somewhat better disease control compared with RIC transplants. The intensity of conditioning regimens should be considered when designing individual allo-SCT strategies or clinical trials in patients with relapsed/refractory HL.
Original languageEnglish
Pages (from-to)2251-2257
Number of pages7
JournalAnnals of Oncology
Volume27
Issue number12
DOIs
Publication statusPublished - Dec 2016

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Stem Cell Transplantation
Hodgkin Disease
Lymphoma
Disease-Free Survival
Recurrence
Transplants
Mortality
Multivariate Analysis
Clinical Trials
Databases
Survival

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  • Journal Article

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Myeloablative versus reduced intensity allogeneic stem cell transplantation for relapsed/refractory Hodgkin's lymphoma in recent years : a retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. / Genadieva-Stavrik, S; Boumendil, A.; Dreger, P.; Peggs, Karl; Briones, Javier; Corradini, P; Bacigalupo, A; Socié, G; Bonifazi, F.; Finel, H.; Velardi, A.; Potter, M.; Bruno, B.; Castagna, L; Malladi, R; Russell, N.; Sureda, A.

In: Annals of Oncology, Vol. 27, No. 12, 12.2016, p. 2251-2257.

Research output: Contribution to journalArticle

Genadieva-Stavrik, S ; Boumendil, A. ; Dreger, P. ; Peggs, Karl ; Briones, Javier ; Corradini, P ; Bacigalupo, A ; Socié, G ; Bonifazi, F. ; Finel, H. ; Velardi, A. ; Potter, M. ; Bruno, B. ; Castagna, L ; Malladi, R ; Russell, N. ; Sureda, A. / Myeloablative versus reduced intensity allogeneic stem cell transplantation for relapsed/refractory Hodgkin's lymphoma in recent years : a retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. In: Annals of Oncology. 2016 ; Vol. 27, No. 12. pp. 2251-2257.
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title = "Myeloablative versus reduced intensity allogeneic stem cell transplantation for relapsed/refractory Hodgkin's lymphoma in recent years: a retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation.",
abstract = "BACKGROUND: To evaluate long-term outcome of myeloablative allogeneic stem cell transplantation (allo-SCT) (MAC) versus reduced-intensity allo-SCT (RIC) in patients with relapsed/refractory Hodgkin's lymphoma (HL) in recent years.PATIENTS AND METHODS: A total of 312 patients (63 MAC and 249 RIC) with relapsed/refractory HL who received allo-SCT between 2006 and 2010 and were reported to the EBMT Database were included in the study.RESULTS: With a median follow-up for alive patients of 56 (26-73) months, there were no significant differences in non-relapse mortality (NRM) between MAC and RIC. Relapse rate (RR) was somewhat lower in the MAC group (41{\%} versus 52{\%} at 24 months, P = 0.16). This lower RR translated into a marginal improvement in event-free survival (EFS) for the MAC group (48{\%} versus 36{\%} at 24 months, P = 0.09) with no significant differences in overall survival (73{\%} for MAC and 62{\%} for RIC at 24 months, P = 0.13). Multivariate analysis after adjusting for disease status at the time of allo-SCT showed that the use of MAC was of borderline statistical significance for predicting a lower RR and EFS [HR 0.7, 95{\%} CI (0.5-1.0), P = 0.1] and [HR 0.7, 95{\%} CI (0.5-1.0), P = 0.07], respectively, after allo-SCT.CONCLUSIONS: With modern transplant practices, the NRM associated with MAC for HL has strongly decreased, resulting into non-significant improvement of EFS because of a somewhat better disease control compared with RIC transplants. The intensity of conditioning regimens should be considered when designing individual allo-SCT strategies or clinical trials in patients with relapsed/refractory HL.",
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TY - JOUR

T1 - Myeloablative versus reduced intensity allogeneic stem cell transplantation for relapsed/refractory Hodgkin's lymphoma in recent years

T2 - a retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation.

AU - Genadieva-Stavrik, S

AU - Boumendil, A.

AU - Dreger, P.

AU - Peggs, Karl

AU - Briones, Javier

AU - Corradini, P

AU - Bacigalupo, A

AU - Socié, G

AU - Bonifazi, F.

AU - Finel, H.

AU - Velardi, A.

AU - Potter, M.

AU - Bruno, B.

AU - Castagna, L

AU - Malladi, R

AU - Russell, N.

AU - Sureda, A.

N1 - © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2016/12

Y1 - 2016/12

N2 - BACKGROUND: To evaluate long-term outcome of myeloablative allogeneic stem cell transplantation (allo-SCT) (MAC) versus reduced-intensity allo-SCT (RIC) in patients with relapsed/refractory Hodgkin's lymphoma (HL) in recent years.PATIENTS AND METHODS: A total of 312 patients (63 MAC and 249 RIC) with relapsed/refractory HL who received allo-SCT between 2006 and 2010 and were reported to the EBMT Database were included in the study.RESULTS: With a median follow-up for alive patients of 56 (26-73) months, there were no significant differences in non-relapse mortality (NRM) between MAC and RIC. Relapse rate (RR) was somewhat lower in the MAC group (41% versus 52% at 24 months, P = 0.16). This lower RR translated into a marginal improvement in event-free survival (EFS) for the MAC group (48% versus 36% at 24 months, P = 0.09) with no significant differences in overall survival (73% for MAC and 62% for RIC at 24 months, P = 0.13). Multivariate analysis after adjusting for disease status at the time of allo-SCT showed that the use of MAC was of borderline statistical significance for predicting a lower RR and EFS [HR 0.7, 95% CI (0.5-1.0), P = 0.1] and [HR 0.7, 95% CI (0.5-1.0), P = 0.07], respectively, after allo-SCT.CONCLUSIONS: With modern transplant practices, the NRM associated with MAC for HL has strongly decreased, resulting into non-significant improvement of EFS because of a somewhat better disease control compared with RIC transplants. The intensity of conditioning regimens should be considered when designing individual allo-SCT strategies or clinical trials in patients with relapsed/refractory HL.

AB - BACKGROUND: To evaluate long-term outcome of myeloablative allogeneic stem cell transplantation (allo-SCT) (MAC) versus reduced-intensity allo-SCT (RIC) in patients with relapsed/refractory Hodgkin's lymphoma (HL) in recent years.PATIENTS AND METHODS: A total of 312 patients (63 MAC and 249 RIC) with relapsed/refractory HL who received allo-SCT between 2006 and 2010 and were reported to the EBMT Database were included in the study.RESULTS: With a median follow-up for alive patients of 56 (26-73) months, there were no significant differences in non-relapse mortality (NRM) between MAC and RIC. Relapse rate (RR) was somewhat lower in the MAC group (41% versus 52% at 24 months, P = 0.16). This lower RR translated into a marginal improvement in event-free survival (EFS) for the MAC group (48% versus 36% at 24 months, P = 0.09) with no significant differences in overall survival (73% for MAC and 62% for RIC at 24 months, P = 0.13). Multivariate analysis after adjusting for disease status at the time of allo-SCT showed that the use of MAC was of borderline statistical significance for predicting a lower RR and EFS [HR 0.7, 95% CI (0.5-1.0), P = 0.1] and [HR 0.7, 95% CI (0.5-1.0), P = 0.07], respectively, after allo-SCT.CONCLUSIONS: With modern transplant practices, the NRM associated with MAC for HL has strongly decreased, resulting into non-significant improvement of EFS because of a somewhat better disease control compared with RIC transplants. The intensity of conditioning regimens should be considered when designing individual allo-SCT strategies or clinical trials in patients with relapsed/refractory HL.

KW - Journal Article

U2 - 10.1093/annonc/mdw421

DO - 10.1093/annonc/mdw421

M3 - Article

VL - 27

SP - 2251

EP - 2257

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 12

ER -