Reduced-intensity allogeneic transplantation in patients with refractory or progressive Hodgkin's disease after high-dose chemotherapy and autologous stem cell infusion

Elisabetta Todisco, Luca Castagna, Barbara Sarina, Rita Mazza, Antonella Anastasia, Monica Balzarotti, Giuseppe Banna, Umberto Tirelli, Davide Soligo, Armando Santoro

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We analysed the feasibility and efficacy of allogeneic stem cell transplantation (allo-SCT) with reduced-intensity conditioning (RIC) in patients with refractory or progressive Hodgkin's disease (HD) after high-dose chemotherapy (HDCT). Patients and methods: Fourteen patients with HD received allo-SCT with RIC: eleven patients had a human leucocytes antigen-identical related donor and three a matched unrelated donor. Six had chemoresistant disease and eight had chemosensitive one at the time of transplantation. All patients received a fludarabine-based RIC. Results: All patients engrafted and full donor chimerism was achieved in all patients. Grade II acute graft-vs.-host disease (GvHD) developed in six of the 14 patients (43%). Chronic GvHD developed in eight of the 13 patients (61%). There was neither early nor late treatment-related mortality (TRM). With a median follow-up of 21 months (range 3-74), 10 of the 14 patients were alive (71%). Estimated overall survival at 1 and 2 yr was 93% and 73%, respectively, for the whole population, 83% and 44% respectively for patients with chemoresistant disease and 100% for those with chemosensitive disease. Estimated progression-free survival at 1 yr was 36%; 62.5% for chemosensitive patients and 0% for those with chemoresistant disease. Conclusions: In conclusion, allo-SCT with fludarabine-based RIC is a feasible procedure, without TRM in HD patients relapsed and refractory after HDCT. Even if several questions are still open, this approach should proposed for these poor prognosis patients.

Original languageEnglish
Pages (from-to)322-329
Number of pages8
JournalEuropean Journal of Haematology
Volume78
Issue number4
DOIs
Publication statusPublished - Apr 2007

Keywords

  • Chemorefractory Hodgkin's disease
  • High-dose chemotherapy
  • Reduced-intensity allogeneic transplantation

ASJC Scopus subject areas

  • Hematology

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