Reduced-intensity conditioning compared with conventional allogeneic stem-cell transplantation in relapsed or refractory Hodgkin's lymphoma: An analysis from the lymphoma working party of the European Group for Blood and Marrow Transplantation

Anna Sureda, Stephen Robinson, Carmen Canals, Angelo M. Carella, Marc A. Boogaerts, Dolores Caballero, Ann E. Hunter, Lothar Kanz, Shimon Slavin, Jan J. Cornelissen, Martin Gramatzki, Dietger Niederwieser, Nigel H. Russell, Norbert Schmitz

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To compare the clinical outcome in terms of nonrelapse mortality (NRM), relapse rate (RR), overall survival (OS), and progression-free survival (PFS) in patients with relapsed Hodgkin's lymphoma (HL) treated with reduced-intensity conditioning (RIC) or myeloablative conditioning followed by allogeneic stem-cell transplantation (alloSCT). Patients and Methods: A total of 168 patients with HL undergoing a first alloSCT (RIC, n = 89; myeloablative conditioning, n = 79) between January 1997 and December 2001 and registered in the European Group for Blood and Marrow Transplantation database were analyzed. Results: NRM was significantly decreased in the RIC group (hazard ratio [HR], 2.85; 95% CI, 1.62 to 5.02; P <.001). OS was better in the RIC group (HR, 2.05; 95% CI, 1.27 to 3.29; P = .04) and there was a trend for better PFS in the RIC group (HR, 1.53; 95% CI, 0.97 to 2.40; P = .07). RR was higher in the RIC group in univariate but not in multivariate analysis. The development of chronic graft-versus-host disease (GVHD) significantly decreased the incidence of relapse, which translated into a trend for a better PFS. Conclusion: The lower incidence of NRM in the RIC group is encouraging, particularly because these patients experienced adverse pretransplantation characteristics more frequently. This analysis also indicates the existence of a graft-versus-HL effect correlated to the development of GVHD. Additional efforts to reduce the high RR seen in both groups of patients will be necessary to improve the modest PFS (31% v 27%) and OS (59% v 36%) for patients prepared with RIC or myeloablative conditioning.

Original languageEnglish
Pages (from-to)455-462
Number of pages8
JournalJournal of Clinical Oncology
Volume26
Issue number3
DOIs
Publication statusPublished - Jan 20 2008

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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