Journal article
Impact of type of reduced-intensity conditioning regimen on the outcomes of allogeneic haematopoietic cell transplantation in classical Hodgkin lymphoma
British journal of haematology, Vol.190(4), pp.573-582
08/01/2020
DOI: 10.1111/bjh.16664
PMCID: PMC7575614
PMID: 32314807
Abstract
Reduced-intensity conditioning (RIC) allogeneic haematopoietic cell transplantation (allo-HCT) is a curative option for select relapsed/refractory Hodgkin lymphoma (HL) patients; however, there are sparse data to support superiority of any particular conditioning regimen. We analyzed 492 adult patients undergoing human leucocyte antigen (HLA)-matched sibling or unrelated donor allo-HCT for HL between 2008 and 2016, utilizing RIC with either fludarabine/busulfan (Flu/Bu), fludarabine/melphalan (Flu/Mel140) or fludarabine/cyclophosphamide (Flu/Cy). Multivariable regression analysis was performed using a significance level of <0 center dot 01. There were no significant differences between regimens in risk for non-relapse mortality (NRM) (P = 0 center dot 54), relapse/progression (P = 0 center dot 02) or progression-free survival (PFS) (P = 0 center dot 14). Flu/Cy conditioning was associated with decreased risk of mortality in the first 11 months after allo-HCT (HR = 0 center dot 28; 95% CI = 0 center dot 10-0 center dot 73; P = 0 center dot 009), but beyond 11 months post allo-HCT it was associated with a significantly higher risk of mortality, (HR = 2 center dot 46; 95% CI = 0 center dot 1.32-4 center dot 61; P = 0 center dot 005). Four-year adjusted overall survival (OS) was similar across regimens at 62% for Flu/Bu, 59% for Flu/Mel140 and 55% for Flu/Cy (P = 0 center dot 64), respectively. These data confirm the choice of RIC for allo-HCT in HL does not influence risk of relapse, NRM or PFS. Although no OS benefit was seen between Flu/Bu and Flu/Mel 140; Flu/Cy was associated with a significantly higher risk of mortality beyond 11 months from allo-HCT (possibly due to late NRM events).
Details
- Title: Subtitle
- Impact of type of reduced-intensity conditioning regimen on the outcomes of allogeneic haematopoietic cell transplantation in classical Hodgkin lymphoma
- Creators
- Sairah Ahmed - Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USANilanjan Ghosh - Levine Cancer InstituteKwang W. Ahn - Medical College of WisconsinManoj Khanal - Medical College of WisconsinCarlos Litovich - Medical College of WisconsinAlberto Mussetti - Institut Català d'OncologiaSaurabh Chhabra - Medical College of WisconsinMitchell Cairo - New York Medical CollegeMatthew Mei - City Of Hope National Medical CenterBasem William - The Ohio State UniversitySunita Nathan - Rush University Medical CenterNelli Bejanyan - Moffitt Cancer CenterRichard F. Olsson - Uppsala UniversityParastoo B. Dahi - Memorial Sloan Kettering Cancer CenterMarjolein van der Poel - Maastricht University Medical CentreAmir Steinberg - Mount Sinai HospitalJennifer Kanakry - National Cancer InstituteJan Cerny - University of Massachusetts Chan Medical SchoolUmar Farooq - University of Iowa Hospitals and ClinicsSachiko Seo - Dokkyo Medical UniversityMohamed A. Kharfan-Dabaja - Mayo Clinic in FloridaAnna Sureda - Institut Català d'OncologiaTimothy S. Fenske - Medical College of WisconsinMehdi Hamadani - Medical College of Wisconsin
- Resource Type
- Journal article
- Publication Details
- British journal of haematology, Vol.190(4), pp.573-582
- DOI
- 10.1111/bjh.16664
- PMID
- 32314807
- PMCID
- PMC7575614
- NLM abbreviation
- Br J Haematol
- ISSN
- 0007-1048
- eISSN
- 1365-2141
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- Medac, GmbH Sanofi Genzyme; Sanofi-Aventis; Genzyme Corporation Juno Therapeutics Jazz Pharmaceuticals, Inc.; Jazz Pharmaceuticals Seattle Genetics Mesoblast Sunesis Pharmaceuticals, Inc. Kite Pharma, Inc. Shire Spectrum Pharmaceuticals, Inc. Karyopharm Therapeutics, Inc. Otsuka Pharmaceutical Co, Ltd. - Japan; Otsuka Pharmaceutical 5U24CA076518 / Public Health Service Grant from the National Cancer Institute (NCI) Millennium, the Takeda Oncology Co. Miltenyi Biotec, Inc. 5U24CA076518 / National Heart, Lung and Blood Institute (NHLBI); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Fred Hutchinson Cancer Research Center 4U10HL069294 / NCI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) PIRCHE AG Cerus Corporation St. Baldrick's Foundation Amgen, Inc.; Amgen Pharmacyclics, LLC Atara Biotherapeutics, Inc. National Marrow Donor Program Novartis Pharmaceuticals Corporation; Novartis Medical College of Wisconsin; General Electric University of Minnesota; University of Minnesota System Takeda Oncology; Takeda Pharmaceutical Company Ltd PCORI; Patient-Centered Outcomes Research Institute - PCORI N00014-17-1-2388; N00014-16-1-2020 / Office of Naval Research Gamida Cell Ltd. Merck Co, Inc.; Merck & Company MesoScale Diagnostics, Inc. Pfizer, Inc; Pfizer Swedish Orphan Biovitrum, Inc. HistoGenetics, Inc. Telomere Diagnostics, Inc. Chimerix, Inc. Immucor Angiocrine Bioscience, Inc. Incyte Corporation Celgene Corporation; Bristol-Myers Squibb Bristol Myers Squibb Oncology; Bristol-Myers Squibb Astellas Pharma US; Astellas Pharmaceuticals Be the Match Foundation MedImmune; AstraZeneca; Medimmune HHSH250201200016C / Health Resources and Services Administration (HRSA/DHHS); United States Department of Health & Human Services; United States Health Resources & Service Administration (HRSA) Amneal Biosciences 4U10HL069294 / NHLBI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Gilead Sciences, Inc.; Gilead Sciences Janssen Scientific Affairs, LLC Actinium Pharmaceuticals, Inc.; Takeda Pharmaceutical Company Ltd Neovii Biotech NA, Inc. 5U24CA076518 / National Institute of Allergy and Infectious Diseases (NIAID); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) bluebird bio, Inc.
- Language
- English
- Date published
- 08/01/2020
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359859602771
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