Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation: A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study

Annalisa Paviglianiti, Karina Tozatto Maio, Vanderson Rocha, Eve Gehlkopf, Noel Milpied, Albert Esquirol, Patrice Chevallier, Didier Blaise, Anne-Claire Gac, Véronique Leblond, Jean Yves Cahn, Manuel Abecasis, Tsila Zuckerman, Harry Schouten, Gunhan Gurman, Marie Thérèse Rubio, Yves Beguin, Lucia Lopez Corral, Arnon Nagler, John A SnowdenYener Koc, Nicola Mordini, Francesca Bonifazi, Fernanda Volt, Chantal Kenzey, Stephen Paul Robinson, Silvia Montoto, Eliane Gluckman, Annalisa Ruggeri

Research output: Contribution to journalArticle

Abstract

Allogeneic stem cell transplantation is an alternative for patients with relapsed or refractory Hodgkin lymphoma (HL), but only limited data on unrelated umbilical cord blood transplantation (UCBT) are available. We analyzed 131 adults with HL who underwent UCBT in European Society for Blood and Marrow Transplantation centers from 2003 to 2015. Disease status at UCBT was complete remission (CR) in 59 patients (47%), and almost all patients had received a previous autologous stem cell transplantation. The 4-year progression-free survival (PFS) and overall survival (OS) were 26% (95% confidence interval [CI], 19% to 34%) and 46% (95% CI, 37% to 55%), respectively. Relapse incidence was 44% (95% CI, 36% to 54%), and nonrelapse mortality (NRM) was 31% (95% CI, 23% to 40%) at 4 years. In multivariate analysis refractory/relapsed disease status at UCBT was associated with increased relapse incidence (hazard ratio [HR], 3.14 [95% CI, 1.41 to 7.00], P = .005) and NRM (HR, 3.61 [95% CI, 1.58 to 8.27], P = .002) and lower PFS (HR, 3.45 [95% CI, 1.95 to 6.10], P < .001) and OS (HR, 3.10 [95% CI, 1.60 to 5.99], P = .001). Conditioning regimen with cyclophosphamide + fludarabine + 2 Gy total body irradiation (Cy+Flu+2GyTBI) was associated with decreased risk of NRM (HR, .26 [95% CI, .10 to .64], P = .004). Moreover, Cy+Flu+2GyTBI conditioning regimen was associated with a better OS (HR, .25 [95% CI, .12 to .50], P < .001) and PFS (HR, .51 [95% CI, .27 to .96], P = .04). UCBT is feasible in heavily pretreated patients with HL. The reduced-intensity conditioning regimen with Cy+Flu+2GyTBI is associated with a better OS and NRM. However, outcomes are poor in patients not in CR at UCBT.

Original languageEnglish
Pages (from-to)2265-2270
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume24
Issue number11
DOIs
Publication statusPublished - Nov 2018
Externally publishedYes

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Hodgkin Disease
Fetal Blood
Lymphoma
Transplantation
Confidence Intervals
Whole-Body Irradiation
Therapeutics
Cyclophosphamide
Disease-Free Survival
Survival
Mortality
Stem Cell Transplantation
Recurrence
Incidence
Multivariate Analysis
Bone Marrow

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Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation : A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study. / Paviglianiti, Annalisa; Tozatto Maio, Karina; Rocha, Vanderson; Gehlkopf, Eve; Milpied, Noel; Esquirol, Albert; Chevallier, Patrice; Blaise, Didier; Gac, Anne-Claire; Leblond, Véronique; Cahn, Jean Yves; Abecasis, Manuel; Zuckerman, Tsila; Schouten, Harry; Gurman, Gunhan; Rubio, Marie Thérèse; Beguin, Yves; Corral, Lucia Lopez; Nagler, Arnon; Snowden, John A; Koc, Yener; Mordini, Nicola; Bonifazi, Francesca; Volt, Fernanda; Kenzey, Chantal; Robinson, Stephen Paul; Montoto, Silvia; Gluckman, Eliane; Ruggeri, Annalisa.

In: Biology of Blood and Marrow Transplantation, Vol. 24, No. 11, 11.2018, p. 2265-2270.

Research output: Contribution to journalArticle

Paviglianiti, A, Tozatto Maio, K, Rocha, V, Gehlkopf, E, Milpied, N, Esquirol, A, Chevallier, P, Blaise, D, Gac, A-C, Leblond, V, Cahn, JY, Abecasis, M, Zuckerman, T, Schouten, H, Gurman, G, Rubio, MT, Beguin, Y, Corral, LL, Nagler, A, Snowden, JA, Koc, Y, Mordini, N, Bonifazi, F, Volt, F, Kenzey, C, Robinson, SP, Montoto, S, Gluckman, E & Ruggeri, A 2018, 'Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation: A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study', Biology of Blood and Marrow Transplantation, vol. 24, no. 11, pp. 2265-2270. https://doi.org/10.1016/j.bbmt.2018.07.019
Paviglianiti, Annalisa ; Tozatto Maio, Karina ; Rocha, Vanderson ; Gehlkopf, Eve ; Milpied, Noel ; Esquirol, Albert ; Chevallier, Patrice ; Blaise, Didier ; Gac, Anne-Claire ; Leblond, Véronique ; Cahn, Jean Yves ; Abecasis, Manuel ; Zuckerman, Tsila ; Schouten, Harry ; Gurman, Gunhan ; Rubio, Marie Thérèse ; Beguin, Yves ; Corral, Lucia Lopez ; Nagler, Arnon ; Snowden, John A ; Koc, Yener ; Mordini, Nicola ; Bonifazi, Francesca ; Volt, Fernanda ; Kenzey, Chantal ; Robinson, Stephen Paul ; Montoto, Silvia ; Gluckman, Eliane ; Ruggeri, Annalisa. / Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation : A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study. In: Biology of Blood and Marrow Transplantation. 2018 ; Vol. 24, No. 11. pp. 2265-2270.
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title = "Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation: A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study",
abstract = "Allogeneic stem cell transplantation is an alternative for patients with relapsed or refractory Hodgkin lymphoma (HL), but only limited data on unrelated umbilical cord blood transplantation (UCBT) are available. We analyzed 131 adults with HL who underwent UCBT in European Society for Blood and Marrow Transplantation centers from 2003 to 2015. Disease status at UCBT was complete remission (CR) in 59 patients (47{\%}), and almost all patients had received a previous autologous stem cell transplantation. The 4-year progression-free survival (PFS) and overall survival (OS) were 26{\%} (95{\%} confidence interval [CI], 19{\%} to 34{\%}) and 46{\%} (95{\%} CI, 37{\%} to 55{\%}), respectively. Relapse incidence was 44{\%} (95{\%} CI, 36{\%} to 54{\%}), and nonrelapse mortality (NRM) was 31{\%} (95{\%} CI, 23{\%} to 40{\%}) at 4 years. In multivariate analysis refractory/relapsed disease status at UCBT was associated with increased relapse incidence (hazard ratio [HR], 3.14 [95{\%} CI, 1.41 to 7.00], P = .005) and NRM (HR, 3.61 [95{\%} CI, 1.58 to 8.27], P = .002) and lower PFS (HR, 3.45 [95{\%} CI, 1.95 to 6.10], P < .001) and OS (HR, 3.10 [95{\%} CI, 1.60 to 5.99], P = .001). Conditioning regimen with cyclophosphamide + fludarabine + 2 Gy total body irradiation (Cy+Flu+2GyTBI) was associated with decreased risk of NRM (HR, .26 [95{\%} CI, .10 to .64], P = .004). Moreover, Cy+Flu+2GyTBI conditioning regimen was associated with a better OS (HR, .25 [95{\%} CI, .12 to .50], P < .001) and PFS (HR, .51 [95{\%} CI, .27 to .96], P = .04). UCBT is feasible in heavily pretreated patients with HL. The reduced-intensity conditioning regimen with Cy+Flu+2GyTBI is associated with a better OS and NRM. However, outcomes are poor in patients not in CR at UCBT.",
author = "Annalisa Paviglianiti and {Tozatto Maio}, Karina and Vanderson Rocha and Eve Gehlkopf and Noel Milpied and Albert Esquirol and Patrice Chevallier and Didier Blaise and Anne-Claire Gac and V{\'e}ronique Leblond and Cahn, {Jean Yves} and Manuel Abecasis and Tsila Zuckerman and Harry Schouten and Gunhan Gurman and Rubio, {Marie Th{\'e}r{\`e}se} and Yves Beguin and Corral, {Lucia Lopez} and Arnon Nagler and Snowden, {John A} and Yener Koc and Nicola Mordini and Francesca Bonifazi and Fernanda Volt and Chantal Kenzey and Robinson, {Stephen Paul} and Silvia Montoto and Eliane Gluckman and Annalisa Ruggeri",
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T1 - Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation

T2 - A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study

AU - Paviglianiti, Annalisa

AU - Tozatto Maio, Karina

AU - Rocha, Vanderson

AU - Gehlkopf, Eve

AU - Milpied, Noel

AU - Esquirol, Albert

AU - Chevallier, Patrice

AU - Blaise, Didier

AU - Gac, Anne-Claire

AU - Leblond, Véronique

AU - Cahn, Jean Yves

AU - Abecasis, Manuel

AU - Zuckerman, Tsila

AU - Schouten, Harry

AU - Gurman, Gunhan

AU - Rubio, Marie Thérèse

AU - Beguin, Yves

AU - Corral, Lucia Lopez

AU - Nagler, Arnon

AU - Snowden, John A

AU - Koc, Yener

AU - Mordini, Nicola

AU - Bonifazi, Francesca

AU - Volt, Fernanda

AU - Kenzey, Chantal

AU - Robinson, Stephen Paul

AU - Montoto, Silvia

AU - Gluckman, Eliane

AU - Ruggeri, Annalisa

N1 - Copyright © 2018. Published by Elsevier Inc.

PY - 2018/11

Y1 - 2018/11

N2 - Allogeneic stem cell transplantation is an alternative for patients with relapsed or refractory Hodgkin lymphoma (HL), but only limited data on unrelated umbilical cord blood transplantation (UCBT) are available. We analyzed 131 adults with HL who underwent UCBT in European Society for Blood and Marrow Transplantation centers from 2003 to 2015. Disease status at UCBT was complete remission (CR) in 59 patients (47%), and almost all patients had received a previous autologous stem cell transplantation. The 4-year progression-free survival (PFS) and overall survival (OS) were 26% (95% confidence interval [CI], 19% to 34%) and 46% (95% CI, 37% to 55%), respectively. Relapse incidence was 44% (95% CI, 36% to 54%), and nonrelapse mortality (NRM) was 31% (95% CI, 23% to 40%) at 4 years. In multivariate analysis refractory/relapsed disease status at UCBT was associated with increased relapse incidence (hazard ratio [HR], 3.14 [95% CI, 1.41 to 7.00], P = .005) and NRM (HR, 3.61 [95% CI, 1.58 to 8.27], P = .002) and lower PFS (HR, 3.45 [95% CI, 1.95 to 6.10], P < .001) and OS (HR, 3.10 [95% CI, 1.60 to 5.99], P = .001). Conditioning regimen with cyclophosphamide + fludarabine + 2 Gy total body irradiation (Cy+Flu+2GyTBI) was associated with decreased risk of NRM (HR, .26 [95% CI, .10 to .64], P = .004). Moreover, Cy+Flu+2GyTBI conditioning regimen was associated with a better OS (HR, .25 [95% CI, .12 to .50], P < .001) and PFS (HR, .51 [95% CI, .27 to .96], P = .04). UCBT is feasible in heavily pretreated patients with HL. The reduced-intensity conditioning regimen with Cy+Flu+2GyTBI is associated with a better OS and NRM. However, outcomes are poor in patients not in CR at UCBT.

AB - Allogeneic stem cell transplantation is an alternative for patients with relapsed or refractory Hodgkin lymphoma (HL), but only limited data on unrelated umbilical cord blood transplantation (UCBT) are available. We analyzed 131 adults with HL who underwent UCBT in European Society for Blood and Marrow Transplantation centers from 2003 to 2015. Disease status at UCBT was complete remission (CR) in 59 patients (47%), and almost all patients had received a previous autologous stem cell transplantation. The 4-year progression-free survival (PFS) and overall survival (OS) were 26% (95% confidence interval [CI], 19% to 34%) and 46% (95% CI, 37% to 55%), respectively. Relapse incidence was 44% (95% CI, 36% to 54%), and nonrelapse mortality (NRM) was 31% (95% CI, 23% to 40%) at 4 years. In multivariate analysis refractory/relapsed disease status at UCBT was associated with increased relapse incidence (hazard ratio [HR], 3.14 [95% CI, 1.41 to 7.00], P = .005) and NRM (HR, 3.61 [95% CI, 1.58 to 8.27], P = .002) and lower PFS (HR, 3.45 [95% CI, 1.95 to 6.10], P < .001) and OS (HR, 3.10 [95% CI, 1.60 to 5.99], P = .001). Conditioning regimen with cyclophosphamide + fludarabine + 2 Gy total body irradiation (Cy+Flu+2GyTBI) was associated with decreased risk of NRM (HR, .26 [95% CI, .10 to .64], P = .004). Moreover, Cy+Flu+2GyTBI conditioning regimen was associated with a better OS (HR, .25 [95% CI, .12 to .50], P < .001) and PFS (HR, .51 [95% CI, .27 to .96], P = .04). UCBT is feasible in heavily pretreated patients with HL. The reduced-intensity conditioning regimen with Cy+Flu+2GyTBI is associated with a better OS and NRM. However, outcomes are poor in patients not in CR at UCBT.

U2 - 10.1016/j.bbmt.2018.07.019

DO - 10.1016/j.bbmt.2018.07.019

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EP - 2270

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

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