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 nonmyeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose posttransplantation 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 (40.5 Â 10 9 /L) and platelet recovery (420 Â 10 9 /L) of þ 18 and þ 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.

T-replete haploidentical allogeneic transplantation using post-transplantation cyclophosphamide in advanced AML and myelodysplastic syndromes

“…Moreover, most of data on PT-Cy Haplo-SCT included various diagnoses of hematological malignancies, making difficult the accurate evaluation of the efficacy for specific diseases. Although some reports specifically addressed this question for lymphoid diseases, [4][5][6] few data of PT-Cy Haplo-SCT for AML or myelodysplastic syndromes (MDSs) are available so far. Therefore, we investigated the outcome of patients with refractory or high-risk CR AML or MDS undergoing PT-Cy Haplo-SCT in a joint bi-institutional transplantation program.…”

Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT

“…9,10 Outcomes for matched unrelated donor allografting now appear comparable with those seen with matched sibling donor HCT. 3,4,11,12 Reduced-intensity conditioning (RIC) regimens have further extended the use of allogeneic HCT to older patients and those with significant pre-transplant comorbidities. 9,13,14 Several previous studies comparing the clinical outcomes of RIC and MAC regimens after matched related or unrelated donor HCT in AML have shown similar outcomes; [13][14][15][16] however, it is unknown in patients receiving mismatched unrelated donor (MM-URD) HCT.…”

B-cell reconstitution recapitulates B-cell lymphopoiesis following haploidentical BM transplantation and post-transplant CY

“…1 Importantly, the infection-related mortality was remarkably low, suggesting effective immune reconstitution. 1,2 However, a detailed analysis in this regard is missing. Here we show the dynamics of the B-cell compartment.…”