Thomson, KJ and Peggs, KS and Smith, P and Cavet, J and Hunter, A and Parker, A and Pettengell, R and Milligan, D and Morris, EC and Goldstone, AH and Linch, DC and Mackinnon, S (2008) Superiority of reduced-intensity allogeneic transplantation over conventional treatment for relapse of Hodgkin's lymphoma following autologous stem cell transplantation. BONE MARROW TRANSPL , 41 (9) 765 - 770. 10.1038/sj.bmt.1705977.
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This study compares outcome of reduced-intensity conditioned transplant (RIT) with outcome of conventional non-transplant therapy in patients with Hodgkin's lymphoma relapsing following autograft. There were 72 patients in two groups who had relapsed, and received salvage therapy with chemotherapy +/- radiotherapy. One group (n = 38) then underwent alemtuzumab-containing RIT. The second group-historical controls (n = 34), relapsing before the advent of RIT-had no further high-dose therapy. This group was required to respond to salvage therapy and live for over 12 months post-relapse, demonstrating potential eligibility for RIT, had this been available. Overall survival (OS) from diagnosis was superior following RIT (48% at 10 years versus 15%; P = 0.0014), as was survival from autograft (65% at 5 years versus 15%; P <= 0.0001). For the RIT group, OS at 5 years from allograft was 51%, and in chemoresponsive patients was 58%, with current progression-free survival of 42%. Responses were seen in 8 of 15 patients receiving donor lymphocyte infusions (DLI) for relapse/progression, with durable remission in five patients at median follow-up from DLI of 45 months (28-55). These data demonstrate the potential efficacy of RIT in heavily pre-treated patients whose outlook with conventional therapy is dismal, and provide evidence of a clinically relevant graft-versus-lymphoma effect.
|Title:||Superiority of reduced-intensity allogeneic transplantation over conventional treatment for relapse of Hodgkin's lymphoma following autologous stem cell transplantation|
|Keywords:||Hodgkin's lymphoma, allogeneic transplantation, autologous transplantation, BONE-MARROW-TRANSPLANTATION, RANDOMIZED-TRIAL, CLINICAL-COURSE, DISEASE, GVHD, MORTALITY, SURVIVAL, THERAPY, BLOOD|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Infection and Immunity (Division of) > Research Department of Immunology|
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Wolfson Institute and Cancer Institute Administration > Cancer Institute > Research Department of Haematology
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