Double umbilical cord blood transplant is effective therapy for relapsed or refractory Hodgkin lymphoma

Thompson, Philip A.; Perera, Travis; Marín, David; Oran, Betül; Popat, Uday; Qazilbash, Muzaffar H.; Shah, Nina; Parmar, Simrit; Rezvani, Katy; Olson, Amanda; Kebriaei, Partow; Anderlini, Paolo; Rondón, Gabriela; Alousi, Amin M.; Ciurea, Stefan O.; Champlin, Richard E.; Bajel, Ashish; Szer, Jeffrey; Shpall, Elizabeth J.; Ritchie, David; Hosing, Chitra

doi:10.3109/10428194.2015.1105370

Cited by 19 publications

(16 citation statements)

References 46 publications

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“…In this study patients who received low-dose TBI had better OS and PFS and lower NRM in the multivariate analysis [24]. Thompson et al [26] showed the results of 27 patients with HL undergoing UCBT with RIC and MAC regimens, with a 5-year PFS, RI, and NRM of 31%, 38%, and 26%, respectively. Our results are in line with previous reports, supporting these findings in a more comprehensive and uniform cohort of patients who received UCBT.…”

Section: Discussionmentioning

confidence: 60%

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Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation: A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study

Paviglianiti

Maio

Rocha

et al. 2018

Biology of Blood and Marrow Transplantation

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Allogeneic stem cell transplantation is an alternative for patients with relapsed or refractory Hodgkin lymphoma (HL), but only limited data on unrelated umbilical cord blood transplantation (UCBT) are available. We analyzed 131 adults with HL who underwent UCBT in European Society for Blood and Marrow Transplantation centers from 2003 to 2015. Disease status at UCBT was complete remission (CR) in 59 patients (47%), and almost all patients had received a previous autologous stem cell transplantation. The 4-year progression-free survival (PFS) and overall survival (OS) were 26% (95% confidence interval [CI], 19% to 34%) and 46% (95% CI, 37% to 55%), respectively. Relapse incidence was 44% (95% CI, 36% to 54%), and nonrelapse mortality (NRM) was 31% (95% CI, 23% to 40%) at 4 years. In multivariate analysis refractory/relapsed disease status at UCBT was associated with increased relapse incidence (hazard ratio [HR], 3.14 [95% CI, 1.41 to 7.00], P = .005) and NRM (HR, 3.61 [95% CI, 1.58 to 8.27], P = .002) and lower PFS (HR, 3.45 [95% CI, 1.95 to 6.10], P < .001) and OS (HR, 3.10 [95% CI, 1.60 to 5.99], P = .001). Conditioning regimen with cyclophosphamide + fludarabine + 2 Gy total body irradiation (Cy+Flu+2GyTBI) was associated with decreased risk of NRM (HR, .26 [95% CI, .10 to .64], P = .004). Moreover, Cy+Flu+2GyTBI conditioning regimen was associated with a better OS (HR, .25 [95% CI, .12 to .50], P < .001) and PFS (HR, .51 [95% CI, .27 to .96], P = .04). UCBT is feasible in heavily pretreated patients with HL. The reduced-intensity conditioning regimen with Cy+Flu+2GyTBI is associated with a better OS and NRM. However, outcomes are poor in patients not in CR at UCBT.

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Section: Discussionmentioning

confidence: 60%

“…This study reports 1 of the largest series of HL patients given UCBT. To date, there are limited studies in this settings, with few patients reported [20,[22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation: A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study

Paviglianiti

Maio

Rocha

et al. 2018

Biology of Blood and Marrow Transplantation

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“…Single center and registry retrospective series are also emerging reporting disease-specific outcomes in patients with acute myelogenous leukemia (AML) 11, 12 , acute lymphoblastic leukemia 13,14 , myelodysplasia 15 , myelofibrosis 16,17 , non-Hodgkins or Hodgkin lymphoma 18–20 , and multiple myeloma 21,22 . In addition, a number of prospective studies have now been reported.…”

Section: Introductionmentioning

confidence: 99%

Optimal Practices in Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies

Barker

Kurtzberg

Ballen

et al. 2017

Biology of Blood and Marrow Transplantation

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120

115

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Unrelated donor cord blood (CB) transplantation (CBT) results in disease-free survival comparable to that of unrelated adult donor transplantation in patients with hematologic malignancies. Extension of allograft access to racial and ethnic minorities, rapid graft availability, flexibility of transplant date, and low risks of disabling chronic graft-versus-host disease (GVHD) and relapse are significant advantages of CBT, and multiple series have reported a low risk of late transplant-related mortality (TRM) post-transplant. Nonetheless, early post-transplant morbidity and TRM and the requirement for intensive early post-transplant management have slowed wide adoption of CBT. Targeted care strategies in CBT recipients can, however, mitigate early transplant complications and reduce transplant costs. Herein, we provide a practical “how to” guide to CBT for hematologic malignancies on behalf of the NMDP and the ASBMT CB Special Interest Group (SIG). It shares the best practices of 6 experienced United States transplant centers with a special interest in the use of CB as a hematopoietic stem cell source. We address donor search and unit selection, unit thaw and infusion, conditioning regimens, immune suppression, management of GVHD, opportunistic infections and other factors in supportive care appropriate for CBT. Meticulous attention to such details has improved CBT outcomes and will facilitate the success of CBT as a platform for future graft manipulations.

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“…The use of low-dose TBI in that report was associated with lower risk of engraftment failure 15 . A more recent study of 27 patients who received dUCB alloSCT for relapsed/refractory HL at two centers reported a 26% TRM at 100 days with two-year PFS and OS of 41% and 56%, respectively 16 . In this study, 5/11 dUCB transplants (45%) had relapsed/refractory HL.…”

Section: Discussionmentioning

confidence: 55%

Outcomes of allogeneic hematopoietic stem cell transplantation for lymphomas: a single-institution experience

Massoud

Caimi

Ferrari

et al. 2016

Revista Brasileira de Hematologia e Hemoterapia

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IntroductionAllogeneic hematopoietic stem cell transplantation offers the opportunity for extended survival in patients with Hodgkin's and non-Hodgkin lymphomas who relapsed after, or were deemed ineligible for, autologous transplantation. This study reports the cumulative experience of a single center over the past 14 years aiming to define the impact of patient, disease, and transplant-related characteristics on outcomes.MethodsAll patients with histologically confirmed diagnosis of Hodgkin's or non-Hodgkin lymphomas who received allogeneic transplantation from 2000 to 2014 were retrospectively studied.ResultsForty-one patients were reviewed: 10 (24%) had Hodgkin's and 31 (76%) had non-Hodgkin lymphomas. The median age was 50 years and 23 (56%) were male. The majority of patients (68%) had had a prior autologous transplantation. At the time of allogeneic transplantation, 18 (43%) patients were in complete and seven (17%) were in partial remission. Most (95%) patients received reduced-intensity conditioning, 49% received matched sibling donor grafts, 24% matched-unrelated donor grafts, and 27% received double umbilical cord blood grafts. The 100-day treatment-related mortality rate was 12%. After a median duration of follow up of 17.1 months, the median progression-free and overall survival was 40.5 and 95.8 months, respectively. On multivariate analysis, patients who had active disease at the time of transplant had inferior survival.ConclusionsAllogeneic transplantation results extend survival in selected patients with relapsed/refractory Hodgkin's and non-Hodgkin lymphomas with low treatment-related mortality. Patients who have active disease at the time of allogeneic transplantation have poor outcomes.

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Double umbilical cord blood transplant is effective therapy for relapsed or refractory Hodgkin lymphoma

Cited by 19 publications

References 46 publications

Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation: A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study

Outcomes of Advanced Hodgkin Lymphoma after Umbilical Cord Blood Transplantation: A Eurocord and EBMT Lymphoma and Cellular Therapy & Immunobiology Working Party Study

Optimal Practices in Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies

Outcomes of allogeneic hematopoietic stem cell transplantation for lymphomas: a single-institution experience

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