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  3. Lower Graft-versus-Host Disease and Relapse Risk in Post-Transplant Cyclophosphamide-Based Haploidentical versus Matched Sibling Donor Reduced-Intensity Conditioning Transplant for Hodgkin Lymphoma.
 

Lower Graft-versus-Host Disease and Relapse Risk in Post-Transplant Cyclophosphamide-Based Haploidentical versus Matched Sibling Donor Reduced-Intensity Conditioning Transplant for Hodgkin Lymphoma.

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BORIS DOI
10.7892/boris.133199
Date of Publication
September 2019
Publication Type
Article
Division/Institute

Universitätsklinik fü...

Author
Ahmed, Sairah
Kanakry, Jennifer A
Ahn, Kwang W
Litovich, Carlos
Abdel-Azim, Hisham
Aljurf, Mahmoud
Bacher, Vera Ulrike
Universitätsklinik für Hämatologie und Hämatologisches Zentrallabor
Bejanyan, Nelli
Cohen, Jonathon B
Farooq, Umar
Fuchs, Ephraim J
Bolaños-Meade, Javier
Ghosh, Nilanjan
Herrera, Alex F
Hossain, Nasheed M
Inwards, David
Kanate, Abraham S
Martino, Rodrigo
Munshi, Pashna N
Murthy, Hemant
Mussetti, Alberto
Nieto, Yago
Perales, Miguel-Angel
Romee, Rizwan
Savani, Bipin N
Seo, Sachiko
Wirk, Baldeep
Yared, Jean A
Sureda, Ana
Fenske, Timothy S
Hamadani, Mehdi
Subject(s)

600 - Technology::610...

Series
Biology of blood and marrow transplantation
ISSN or ISBN (if monograph)
1083-8791
Publisher
Elsevier
Language
English
Publisher DOI
10.1016/j.bbmt.2019.05.025
PubMed ID
31132455
Uncontrolled Keywords

Allogeneic transplant...

Description
Classic Hodgkin lymphoma (cHL) patients with relapsed or refractory disease may benefit from allogeneic hematopoietic cell transplantation (allo-HCT), but many lack a matched sibling donor (MSD). Herein, we compare outcomes of 2 reduced-intensity conditioning (RIC) HCT platforms in cHL: T cell-replete related donor haploidentical (haplo) HCT with a post-transplant cyclophosphamide (PTCy)-based approach versus an MSD/calcineurin inhibitor (CNI)-based approach. The study included 596 adult patients who underwent a first RIC allo-HCT for cHL between 2008 and 2016 using either a haplo-PTCy (n = 139) or MSD/CNI-based (n = 457) approach. Overall survival (OS) was the primary endpoint. Secondary endpoints included acute graft-versus-host disease (aGVHD) and chronic GVHD (cGVHD), nonrelapse mortality (NRM), relapse/progression, and progression-free survival (PFS). On multivariate analysis, there was no significant difference between haplo/PTCy and MDS/CNI-based approaches in terms of OS (hazard ratio [HR], 1.07; 95% confidence interval [CI], .79 to 1.45; P = .66) or PFS (HR, .86; 95% CI, .68 to 1.10; P = .22). Haplo/PTCy was associated with a significantly higher risk of grades II to IV aGVHD (odds ratio [OR], 1.73, 95% CI, 1.16 to 2.59; P = .007), but the risk of grades III to IV aGVHD was not significantly different between the 2 cohorts (OR, .61; 95% CI, .29 to 1.27; P = .19). The haplo/PTCy platform provided a significant reduction in cGVHD risk (HR, .45; 95% CI, .32 to .64; P < .001), and a significant reduction in relapse risk (HR, .74; 95% CI, .56 to .97; P = .03). There was a statistically nonsignificant trend toward higher NRM with a haplo/PTCy approach (HR, 1.65; 95% CI, .99 to 2.77; P = .06). Haplo/PTCy-based approaches are associated with lower incidences of cGVHD and relapse, with PFS and OS outcomes comparable with MSD/CNI-based approaches. There was a leaning toward higher NRM with a haplo/PTCy-based platform. These data show that haplo/PTCy allo-HCT in cHL results in survival comparable with MSD/CNI-based allo-HCT.
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/182095
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