Tandem haematopoietic stem cell transplantation for High Risk relapsed/refractory Hodgkin Lymphoma: a LYSA study.
Fiche publication
Date publication
mai 2018
Journal
British journal of haematology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr FORNECKER Luc-Matthieu
Tous les auteurs :
Deau B, Amorim S, Perrot A, Quittet P, Cornillon J, Chaoui D, Marolleau JP, Oberic L, Le Du K, Fornecker LM, Tournilhac O, Veillard AS, Chaillol I, Robin M, Tamburini J, Brice P
Lien Pubmed
Résumé
Tandem stem cell transplantation (SCT) is an option for high-risk relapsed/refractory Hodgkin Lymphoma (HL) patients. We evaluated the tolerance/efficacy of double autologous or autologous SCT (ASCT) followed by allogenic SCT (alloSCT) in 120 HL patients prospectively registered on a French nationwide database. Median age was 26 (14-56) years. Complete remission rate was 60%, including 33% after a single line, and another 27% after two or more salvage regimens. Partial response rate was 32%, and 8% suffered treatment failure. Overall, 115 (96%) patients underwent a first ASCT, and 73 (61%) had a tandem SCT, including alloSCT in 44 (60%) and ASCT in 29 (40%). The median follow-up was 43 months (4.8-73.7 months). The two-year progression-free survival rate for the whole population and for patients receiving tandem transplant was 56% (95% confidence interval [CI]: 46-65%) and 71% (95% CI: 49-84%), respectively. Among tandem transplants, we observed 20 deaths (17%), 10 of which were transplant-related (6 alloSCT and 4 ASCT). We suggest that tandem SCT is efficient in high-risk relapsed/refractory HL patients, although transplant-related mortality remains high. The benefit of tandem SCT should be balanced with the efficacy of Brentuximab vedotin-based post-transplant consolidative strategies in high-risk relapsed/refractory HL patients.
Mots clés
HSCT , Hodgkin lymphoma, brentuximab vedotin, positron emission tomography
Référence
Br. J. Haematol.. 2018 May;181(3):341-349