Nonmyeloablative Conditioning Regimen before T Cell Replete Haploidentical Transplantation with Post-Transplant Cyclophosphamide for Advanced Hodgkin and Non-Hodgkin Lymphomas

IF 4.3 Q1 Medicine
Catalina Montes de Oca , Luca Castagna , Chiara De Philippis , Stefania Bramanti , Jean Marc Schiano , Thomas Pagliardini , Aude Collignon , Samia Harbi , Jacopo Mariotti , Angela Granata , Valerio Maisano , Sabine Furst , Faezeah Legrand , Christian Chabannon , Carmelo Carlo-Stella , Armando Santoro , Didier Blaise , Raynier Devillier
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引用次数: 4

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a valid option in patients with refractory lymphomas. HLA haploidentical stem cell transplantation (haplo-SCT) expanded the accessibility to allogeneic hematopoietic cell transplantation. The aims of study were to retrospectively assess the toxicity and efficacy of haplo-SCT using nonmyeloablative conditioning in patients with advanced lymphoma. In total, 147 patients with advanced lymphoma at 2 partner institutions were included. Patients received a uniform nonmyeloablative conditioning regimen and graft-versus-host disease (GVHD) prophylaxis. The primary endpoints were progression-free survival (PFS), overall survival (OS), GVHD, nonrelapse mortality, and GVHD, relapse-free survival (GRFS). Median follow-up was 39 months (range, 6 to 114 months). The median age was 46 years (range, 19 to 71 years). Sixty-five percent of patients were in complete remission (CR) at transplantation. Cumulative incidence of grade II to IV acute GVHD was 30% (95% confidence interval [Cl], 23% to 38%). Two-year cumulative incidence of all grades of chronic GVHD was 13% (95% CI, 8% to 20%). Two-year cumulative incidence of disease relapse was 19% (95% CI, 14% to 27%), with a higher incidence in patients not being in CR at allo-HCT (CR versus not CR: 12% versus 33%, P = .006). Two-year PFS, OS, and GRFS were 66% (95% CI, 59-75), 73% (95% CI, 66-81), and 56% (95% CI, 48-65), respectively. Haplo-SCT with post-transplantation cyclophosphamide may be considered a valid option for patients with aggressive lymphoma and deserves further evaluation.

晚期霍奇金淋巴瘤和非霍奇金淋巴瘤的移植后环磷酰胺T细胞单倍体移植前非清髓调节方案
同种异体造血干细胞移植是治疗难治性淋巴瘤的有效方法。HLA单倍体干细胞移植(haploo - sct)扩大了异体造血细胞移植的可及性。本研究的目的是回顾性评估晚期淋巴瘤患者采用非清髓性条件下单倍体细胞移植的毒性和疗效。共纳入2家合作机构147例晚期淋巴瘤患者。患者接受统一的非清髓性调节方案和移植物抗宿主病(GVHD)预防。主要终点为无进展生存期(PFS)、总生存期(OS)、GVHD、非复发死亡率和GVHD、无复发生存期(GRFS)。中位随访为39个月(6至114个月)。中位年龄为46岁(范围19 - 71岁)。65%的患者移植后完全缓解(CR)。II级至IV级急性GVHD的累积发病率为30%(95%可信区间[Cl], 23%至38%)。所有级别慢性GVHD的两年累积发病率为13% (95% CI, 8% - 20%)。两年累积疾病复发率为19% (95% CI, 14% - 27%),在异位hct时未处于CR的患者中发病率更高(CR vs非CR: 12% vs 33%, P = 0.006)。两年PFS、OS和GRFS分别为66% (95% CI, 59-75)、73% (95% CI, 66-81)和56% (95% CI, 48-65)。单倍体sct移植后环磷酰胺可能被认为是侵袭性淋巴瘤患者的有效选择,值得进一步评估。
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来源期刊
CiteScore
6.60
自引率
0.00%
发文量
1061
审稿时长
3-6 weeks
期刊介绍: Biology of Blood and Marrow Transplantation publishes original research reports, reviews, editorials, commentaries, letters to the editor, and hypotheses and is the official publication of the American Society for Transplantation and Cellular Therapy. The journal focuses on current technology and knowledge in the interdisciplinary field of hematopoetic stem cell transplantation.
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