BACKGROUND: We analysed the feasibility and efficacy of allogeneic stem cell transplantation (allo-SCT) with reduced-intensity conditioning (RIC) in patients with refractory or progressive Hodgkin's disease (HD) after high-dose chemotherapy (HDCT). PATIENTS AND METHODS: Fourteen patients with HD received allo-SCT with RIC: eleven patients had a human leucocytes antigen-identical related donor and three a matched unrelated donor. Six had chemoresistant disease and eight had chemosensitive one at the time of transplantation. All patients received a fludarabine-based RIC. RESULTS: All patients engrafted and full donor chimerism was achieved in all patients. Grade II acute graft-vs.-host disease (GvHD) developed in six of the 14 patients (43%). Chronic GvHD developed in eight of the 13 patients (61%). There was neither early nor late treatment-related mortality (TRM). With a median follow-up of 21 months (range 3-74), 10 of the 14 patients were alive (71%). Estimated overall survival at 1 and 2 yr was 93% and 73%, respectively, for the whole population, 83% and 44% respectively for patients with chemoresistant disease and 100% for those with chemosensitive disease. Estimated progression-free survival at 1 yr was 36%; 62.5% for chemosensitive patients and 0% for those with chemoresistant disease. CONCLUSIONS: In conclusion, allo-SCT with fludarabine-based RIC is a feasible procedure, without TRM in HD patients relapsed and refractory after HDCT. Even if several questions are still open, this approach should proposed for these poor prognosis patients.
BACKGROUND: We analysed the feasibility and efficacy of allogeneic stem cell transplantation (allo-SCT) with reduced-intensity conditioning (RIC) in patients with refractory or progressive Hodgkin's disease (HD) after high-dose chemotherapy (HDCT). PATIENTS AND METHODS: Fourteen patients with HD received allo-SCT with RIC: eleven patients had a human leucocytes antigen-identical related donor and three a matched unrelated donor. Six had chemoresistant disease and eight had chemosensitive one at the time of transplantation. All patients received a fludarabine-based RIC. RESULTS: All patients engrafted and full donor chimerism was achieved in all patients. Grade II acute graft-vs.-host disease (GvHD) developed in six of the 14 patients (43%). Chronic GvHD developed in eight of the 13 patients (61%). There was neither early nor late treatment-related mortality (TRM). With a median follow-up of 21 months (range 3-74), 10 of the 14 patients were alive (71%). Estimated overall survival at 1 and 2 yr was 93% and 73%, respectively, for the whole population, 83% and 44% respectively for patients with chemoresistant disease and 100% for those with chemosensitive disease. Estimated progression-free survival at 1 yr was 36%; 62.5% for chemosensitive patients and 0% for those with chemoresistant disease. CONCLUSIONS: In conclusion, allo-SCT with fludarabine-based RIC is a feasible procedure, without TRM in HDpatients relapsed and refractory after HDCT. Even if several questions are still open, this approach should proposed for these poor prognosis patients.
Authors: L Castagna; S Bramanti; S Furst; L Giordano; R Crocchiolo; B Sarina; E Mauro; L Morabito; R Bouabdallah; D Coso; M Balzarotti; F Broussais; J El-Cheikh; C C Stella; E Brusamolino; D Blaise; A Santoro Journal: Bone Marrow Transplant Date: 2014-09-15 Impact factor: 5.483
Authors: A Raiola; A Dominietto; R Varaldo; A Ghiso; F Galaverna; S Bramanti; E Todisco; B Sarina; L Giordano; A Ibatici; A Santoro; M Clavio; A Bacigalupo; L Castagna Journal: Bone Marrow Transplant Date: 2013-11-04 Impact factor: 5.483
Authors: A Rambaldi; A Bacigalupo; R Fanin; F Ciceri; F Bonifazi; M Falda; G Lambertenghi-Deliliers; F Benedetti; B Bruno; P Corradini; P E Alessandrino; P Iacopino; W Arcese; R Scimè; R Raimondi; S Sica; L Castagna; T Lamparelli; R Oneto; L Lombardini; S Pollichieni; A Algarotti; A Carobbio; N Sacchi; A Bosi Journal: Leukemia Date: 2012-03-01 Impact factor: 11.528