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Reduced intensity allogeneic hematopoietic cell transplantation can induce durable remission in heavily pretreated relapsed Hodgkin lymphoma
Authors:Robert Chen  Joycelynne M Palmer  Leslie Popplewell  Jessica Shen  Eileen Smith  Maria Delioukina  Neil Kogut  Joseph Rosenthal  Stephen Forman  Auayporn Nademanee
Institution:(1) Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA 91010, USA;(2) Division of Biostatistics, City of Hope National Medical Center, Duarte, CA 91010, USA;(3) City of Hope–Kaiser Permanente, Los Angeles, CA, USA;(4) Department of Pediatric Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA 91010, USA
Abstract:Hodgkin lymphoma (HL) can be aggressive and intractable in some cases. Patients who relapse after autologous HCT (auto-HCT) have limited treatment options. City of Hope reports our experience in the use of reduced intensity allogeneic hematopoietic cell transplantation (allo-HCT) in 24 heavily pretreated patients with relapsed HL, between January 2003 and December 2008. The median number of prior therapies was 5; 20/24 patients had prior auto-HCT. The conditioning regimen for all patients was fludarabine and melphalan. With a median follow-up for living patients of 39.0 months, at 2 years the overall survival (OS) was 60% (95% CI 42, 72) and the progression-free survival was 27% (95% CI 22, 32). Non-relapse mortality was 13.1% (95% CI 5.1, 31.4) at 2 years. The incidence of grade II–IV aGVHD was 45.8% and 8.3% for grade III–IV. Allo-HCT in heavily pretreated relapsed Hodgkin lymphoma is feasible, tolerable, and can induce durable clinical remissions.
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