Allogeneic transplantation improves the overall and progression-free survival of Hodgkin lymphoma patients relapsing after autologous transplantation: a retrospective study based on the time of HLA typing and donor availability
Allogeneic transplantation improves the overall and progression-free survival of Hodgkin lymphoma patients relapsing after autologous transplantation: a retrospective study based on the time of HLA typing and donor availability
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DOI：
10.1182/blood-2009-12-253856
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发表时间：
2010-05-06
期刊：
影响因子：
20.3
通讯作者：
Corradini, Paolo
中科院分区：
文献类型：
--
作者：
Sarina, Barbara;Castagna, Luca;Corradini, Paolo
自体移植（autoSCT）后霍奇金淋巴瘤复发的结果令人沮丧。使用降低强度调节（RIC）的同种异体移植（alloSCT）是一种挽救选择，但其有效性仍不清楚。为了评估 RIC alloSCT 的作用，我们根据主治医生进行挽救性 alloSCT 的承诺设计了一项回顾性研究；因此，仅纳入在 autoSCT 失败后立即进行人类白细胞抗原分型的霍奇金淋巴瘤患者。在 185 名患者中，122 名患者找到了同卵兄弟姐妹 (55%)、匹配的无关兄弟姐妹 (32%) 或半相合兄弟姐妹 (13%) 供体； 63名患者没有找到任何供体。两组的临床特征没有差异。中位随访时间为 48 个月，捐赠组的两年无进展 (PFS) 和总生存 (OS) 更好（分别为 39.3% vs 14.2% 和 66% vs 42%，P < .001）。在多变量分析中，拥有捐赠者对于改善 PFS 和 OS 具有重要意义 (P < .001)。完全缓解的同种异体移植患者表现出更好的 PFS 和 OS。这是在 autoSCT 失败后比较 RIC alloSCT 与传统治疗的最大研究，表明有捐赠者的患者有生存获益。 （血。2010；115（18）：3671-3677）
Hodgkin lymphoma relapsing after autologous transplantation (autoSCT) has a dismal outcome. Allogeneic transplantation (alloSCT) using reduced intensity conditioning (RIC) is a salvage option, but its effectiveness is still unclear. To evaluate the role of RIC alloSCT, we designed a retrospective study based on the commitment of attending physicians to perform a salvage alloSCT; thus, only Hodgkin lymphoma patients having human leukocyte antigen-typing immediately after the failed autoSCT were included. Of 185 patients, 122 found an identical sibling (55%), a matched unrelated (32%) or a haploidentical sibling (13%) donor; 63 patients did not find any donor. Clinical features of both groups did not differ. Two-year progression-free (PFS) and overall survival (OS) were better in the donor group (39.3% vs 14.2%, and 66% vs 42%, respectively, P < .001) with a median follow-up of 48 months. In multivariable analysis, having a donor was significant for better PFS and OS (P < .001). Patients allografted in complete remission showed a better PFS and OS. This is the largest study comparing RIC alloSCT versus conventional treatment after a failed autoSCT, indicating a survival benefit for patients having a donor. (Blood. 2010; 115(18):3671-3677)