Haploidentical related donor compared to HLA-identical donor transplantation for chemosensitive Hodgkin lymphoma patient
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RESEARCH ARTICLE
Open Access
Haploidentical related donor compared to HLA-identical donor transplantation for chemosensitive Hodgkin lymphoma patients Luca Castagna1* , Alessandro Busca2, Stefania Bramanti1, Maria Raiola Anna3, Michele Malagola4, Fabio Ciceri5, William Arcese6, Daniele Vallisa7, Francesca Patriarca8, Giorgina Specchia9, Roberto Raimondi10, Raynier Devillier11, Sabine Furst11, Laura Giordano12, Barbara Sarina1, Jacopo Mariotti1, Attilio Olivieri13, Reda Bouabdallah14, Carmelo Carlo-Stella1, Alessandro Rambaldi15, Armando Santoro1, Paolo Corradini16, Andrea Bacigalupo17, Francesca Bonifazi18 and Didier Blaise11
Abstract Background: Allogeneic stem cell transplantation from haploidentical donor using an unmanipulated graft and post-transplantation cyclophosphamide (PT-Cy) is growing. Haploidentical transplantation with PT-Cy showed a major activity in Hodgkin lymphoma (HL), reducing the relapse incidence. The most important predictive factor of survival and toxicity was disease status before transplantation, which was better in patients with well controlled disease. Methods: We included 198 HL in complete (CR) or partial remission (PR) before transplantation. Sixty-five patients were transplanted from haploidentical donor and 133 from a HLA identical donor (both sibling and unrelated donors). Survival analysis was defined according to the EBMT criteria. Survival curves were generated by using Kaplan-Meier method and differences between groups were compared by the log rank test or by the log rank test for trend when appropriated. Results: The PFS, OS, and RI were significantly better in patients in CR compared to PR (55% vs 29% p = 0.001, 74% vs 55% p = 0.03, 27% vs 55% p < 0.001, respectively). The 2-year PFS was significantly better for HAPLO than HLA-id (63% vs 37%, p = 0.03), without difference in OS. The 1-year NRM was not different. The 2-year relapse incidence (RI) was lower in the HAPLO group (24% vs 44%, p = 0.008). Patients in CR receiving haplo HSCT showed higher 2-year PFS and lower 2-year RI than those allografted with HLA-id donor (75% vs 47%, p < 0.001 and 11% vs 34%, p < 0.001, respectively). In multivariate analysis, donor type and disease status before transplantation were independent predictors of PFS as well as they predict the risk of relapse. Disease status at transplantation and age were independently associated to OS. (Continued on next page)
* Correspondence: [email protected] 1 Humanitas Cancer Center, BMT Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, Rozzano, MI, Italy Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in
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