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Bone Marrow Transplant ; 52(5): 689-696, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28067872

RESUMO

Allogeneic stem cell transplantation (allo-SCT) following a non-myeloablative (NMA) or reduced-intensity conditioning (RIC) is considered a valid approach to treat patients with refractory/relapsed Hodgkin lymphoma (HL). When an HLA-matched donor is lacking a graft from a familial haploidentical (HAPLO) donor, a mismatched unrelated donor (MMUD) or cord blood (CB) might be considered. In this retrospective study, we compared the outcome of patients with HL undergoing a RIC or NMA allo-SCT from HAPLO, MMUD or CB. Ninety-eight patients were included. Median follow-up was 31 months for the whole cohort. All patients in the HAPLO group (N=34) received a T-cell replete allo-SCT after a NMA (FLU-CY-TBI, N=31, 91%) or a RIC (N=3, 9%) followed by post-transplant cyclophosphamide. After adjustment for significant covariates, MMUD and CB were associated with significantly lower GvHD-free relapse-free survival (GRFS; hazard ratio (HR)=2.02, P=0.03 and HR=2.43, P=0.009, respectively) compared with HAPLO donors. In conclusion, higher GRFS was observed in Hodgkin lymphoma patients receiving a RIC or NMA allo-SCT with post-transplant cyclophosphamide from HAPLO donors. Our findings suggest they should be favoured over MMUD and CB in this setting.


Assuntos
Ciclofosfamida/uso terapêutico , Doença de Hodgkin/terapia , Transplante de Células-Tronco/métodos , Condicionamento Pré-Transplante/métodos , Transplante Haploidêntico , Adulto , Transplante de Células-Tronco de Sangue do Cordão Umbilical , Intervalo Livre de Doença , Feminino , Seguimentos , Doença Enxerto-Hospedeiro , Antígenos HLA , Histocompatibilidade , Doença de Hodgkin/mortalidade , Humanos , Masculino , Estudos Retrospectivos , Transplante de Células-Tronco/normas , Transplante Homólogo , Doadores não Relacionados/provisão & distribuição
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