Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin's lymphoma

A. Raiola, A. Dominietto, R. Varaldo, A. Ghiso, F. Galaverna, S. Bramanti, E. Todisco, B. Sarina, L. Giordano, A. Ibatici, A. Santoro, M. Clavio, A. Bacigalupo, L. Castagna

Research output: Contribution to journalArticle

Abstract

Twenty-six patients with advanced Hodgkin's disease received a related HLA haploidentical unmanipulated BMT, following a non-myeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose post-transplantation CY (PT-CY), mycophenolate and a calcineurin inhibitor. All patients had received a previous autograft, and 65% had active disease at the time of BMT. Sustained engraftment of donor cells occurred in 25 patients (96%), with a median time to neutrophil recovery (>0.5 × 109/L) and platelet recovery (>20 × 109/L) of +18 and +23 days from BMT. The incidence of grade II-IV acute GVHD and of chronic GVHD was 24% and 8%, respectively. With a median follow-up of 24 months (range 18-44) 21 patients are alive, 20 disease free. The cumulative incidence of TRM and relapse was 4% and 31%, respectively. The actuarial 3-year survival is 77%, the actuarial 3-year PFS is 63%. In conclusion, we confirm that high-dose PT-CY is effective as prophylaxis of GVHD after HLA haploidentical BMT, can prevent rejection and does not appear to eliminate the allogeneic graft versus lymphoma effect.

Original languageEnglish
Pages (from-to)190-194
Number of pages5
JournalBone Marrow Transplantation
Volume49
Issue number2
DOIs
Publication statusPublished - Feb 2014

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Transplantation Conditioning
Hodgkin Disease
Transplantation
Baltimore
Incidence
Autografts
Lymphoma
Neutrophils
Blood Platelets
Tissue Donors
Transplants
Recurrence
Survival

Keywords

  • Alternative donors
  • Haploidentical transplants
  • Hodgkin's disease

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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title = "Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin's lymphoma",
abstract = "Twenty-six patients with advanced Hodgkin's disease received a related HLA haploidentical unmanipulated BMT, following a non-myeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose post-transplantation CY (PT-CY), mycophenolate and a calcineurin inhibitor. All patients had received a previous autograft, and 65{\%} had active disease at the time of BMT. Sustained engraftment of donor cells occurred in 25 patients (96{\%}), with a median time to neutrophil recovery (>0.5 × 109/L) and platelet recovery (>20 × 109/L) of +18 and +23 days from BMT. The incidence of grade II-IV acute GVHD and of chronic GVHD was 24{\%} and 8{\%}, respectively. With a median follow-up of 24 months (range 18-44) 21 patients are alive, 20 disease free. The cumulative incidence of TRM and relapse was 4{\%} and 31{\%}, respectively. The actuarial 3-year survival is 77{\%}, the actuarial 3-year PFS is 63{\%}. In conclusion, we confirm that high-dose PT-CY is effective as prophylaxis of GVHD after HLA haploidentical BMT, can prevent rejection and does not appear to eliminate the allogeneic graft versus lymphoma effect.",
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author = "A. Raiola and A. Dominietto and R. Varaldo and A. Ghiso and F. Galaverna and S. Bramanti and E. Todisco and B. Sarina and L. Giordano and A. Ibatici and A. Santoro and M. Clavio and A. Bacigalupo and L. Castagna",
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pages = "190--194",
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T1 - Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin's lymphoma

AU - Raiola, A.

AU - Dominietto, A.

AU - Varaldo, R.

AU - Ghiso, A.

AU - Galaverna, F.

AU - Bramanti, S.

AU - Todisco, E.

AU - Sarina, B.

AU - Giordano, L.

AU - Ibatici, A.

AU - Santoro, A.

AU - Clavio, M.

AU - Bacigalupo, A.

AU - Castagna, L.

PY - 2014/2

Y1 - 2014/2

N2 - Twenty-six patients with advanced Hodgkin's disease received a related HLA haploidentical unmanipulated BMT, following a non-myeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose post-transplantation CY (PT-CY), mycophenolate and a calcineurin inhibitor. All patients had received a previous autograft, and 65% had active disease at the time of BMT. Sustained engraftment of donor cells occurred in 25 patients (96%), with a median time to neutrophil recovery (>0.5 × 109/L) and platelet recovery (>20 × 109/L) of +18 and +23 days from BMT. The incidence of grade II-IV acute GVHD and of chronic GVHD was 24% and 8%, respectively. With a median follow-up of 24 months (range 18-44) 21 patients are alive, 20 disease free. The cumulative incidence of TRM and relapse was 4% and 31%, respectively. The actuarial 3-year survival is 77%, the actuarial 3-year PFS is 63%. In conclusion, we confirm that high-dose PT-CY is effective as prophylaxis of GVHD after HLA haploidentical BMT, can prevent rejection and does not appear to eliminate the allogeneic graft versus lymphoma effect.

AB - Twenty-six patients with advanced Hodgkin's disease received a related HLA haploidentical unmanipulated BMT, following a non-myeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose post-transplantation CY (PT-CY), mycophenolate and a calcineurin inhibitor. All patients had received a previous autograft, and 65% had active disease at the time of BMT. Sustained engraftment of donor cells occurred in 25 patients (96%), with a median time to neutrophil recovery (>0.5 × 109/L) and platelet recovery (>20 × 109/L) of +18 and +23 days from BMT. The incidence of grade II-IV acute GVHD and of chronic GVHD was 24% and 8%, respectively. With a median follow-up of 24 months (range 18-44) 21 patients are alive, 20 disease free. The cumulative incidence of TRM and relapse was 4% and 31%, respectively. The actuarial 3-year survival is 77%, the actuarial 3-year PFS is 63%. In conclusion, we confirm that high-dose PT-CY is effective as prophylaxis of GVHD after HLA haploidentical BMT, can prevent rejection and does not appear to eliminate the allogeneic graft versus lymphoma effect.

KW - Alternative donors

KW - Haploidentical transplants

KW - Hodgkin's disease

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