Busulfan-based reduced intensity conditioning regimens for haploidentical transplantation in relapsed/refractory Hodgkin lymphoma: Spanish multicenter experience

Bone Marrow Transplant. 2016 Oct;51(10):1307-1312. doi: 10.1038/bmt.2016.115. Epub 2016 May 9.

Abstract

Relapsed or refractory Hodgkin lymphoma (advanced HL) still remains a therapeutic challenge. Recently, unmanipulated haploidentical related donor transplant with reduced conditioning regimen (HAPLO-RIC) and post-transplant cyclophosphamide (PT-Cy) as GvHD prophylaxis has became a promising rescue strategy potentially available to almost every patient. This paper reports our multicenter experience using an IV busulfan-based HAPLO-RIC regimen and PT-Cy in the treatment of 43 patients with advanced HL. Engraftment occurred in 42 patients (97.5%), with a median time to neutrophil and platelet recovery of 18 and 26 days. Cumulative incidences of grades II-IV acute GvHD and chronic GvHD were 39% and 19%, respectively. With a median follow-up of 25.5 months for survivors, 27 patients are alive, with 22 of them disease free. Cumulative incidences of 1-year non-relapse mortality and relapse at 2 years were 21% and 24%, respectively. The estimated 2-year event-free survival (EFS) and overall survival (OS) were 48% and 58%, respectively. CR prior to HAPLO-RIC correlated with better EFS (78.5% vs 33.5%; P=0.015) and OS (86% vs 46%; P=0.044). Our findings further confirm prior reports using HAPLO-RIC in advanced HL in a multicenter approach employing an IV busulfan-based conditioning regimen.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Busulfan / therapeutic use*
  • Cyclophosphamide / therapeutic use
  • Female
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Hodgkin Disease / complications
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy*
  • Humans
  • Male
  • Middle Aged
  • Salvage Therapy / methods
  • Salvage Therapy / mortality
  • Spain
  • Survival Analysis
  • Transplantation Conditioning / methods*
  • Transplantation, Haploidentical / adverse effects
  • Transplantation, Haploidentical / methods*
  • Transplantation, Haploidentical / mortality
  • Young Adult

Substances

  • Cyclophosphamide
  • Busulfan