Double umbilical cord blood transplant is effective therapy for relapsed or refractory Hodgkin lymphoma. Issue 7 (2nd July 2016)

• Record Type: Journal Article
• Authors: Thompson, Philip A.; Perera, Travis; Marin, David; Oran, Betul; Popat, Uday; Qazilbash, Muzaffar; Shah, Nina; Parmar, Simrit; Rezvani, Katayoun; Olson, Amanda; Kebriaei, Partow; Anderlini, Paolo; Rondon, Gabriela; Alousi, Amin; Ciurea, Stefan; Champlin, Richard E.; Bajel, Ashish; Szer, Jeffrey; Shpall, Elizabeth J.; Ritchie, David; Hosing, Chitra M.
• Is Part Of: Leukemia & lymphoma. Volume 57:Issue 7(2016:Jul.)
• Page Start: 1607
• Page End: 1615
• Publication Date: 2016-07-02
• Subjects: Clinical results -- graft-versus-host disease -- lymphoma and Hodgkin disease; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2015.1105370
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: A sub-group of patients with Hodgkin Lymphoma (HL) who relapse after autologous stem cell transplant can achieve long-term disease-free-survival after allogeneic stem cell transplant (alloSCT). There is limited information regarding the tolerability and efficacy of double umbilical cord blood transplant (dUCBT) for relapsed/refractory HL. We analyzed 27 consecutive, heavily pre-treated patients receiving dUCBT for relapsed/refractory HL at two centers from 2003–2014. The majority of patients relapsed <6 months after autologous stem cell transplant. A total of 15 patients received myeloablative (most commonly melphalan, fludarabine, thiotepa and anti-thymocyte globulin [ATG]) and 12 non-myeloablative conditioning regimens (fludarabine, cyclophosphamide, 200cGy total body irradiation +/- ATG). All patients engrafted; median time to neutrophil and platelet engraftment was 17 and 37 days, respectively. Overall response rate was 68%; 58% achieved complete remission. Median progression-free survival (PFS) was 12.2 months; median overall survival was 27 months. Cumulative incidences of relapse and of non-relapse mortality at 5 years were 30% and 37.9%, respectively; 5-year PFS was 31.3% (95%CI 10.1–52.5). There was a trend toward inferior PFS in patients with lymph node size ≥2 cm at the time of alloSCT ( p = 0.07) and toward inferior survival in patients with chemorefractory disease pre-alloSCT ( p = 0.12). dUCBT is feasible in patients with heavily pre-treated HL and can achieve long-term disease-free survival in approximately 30% of patients.