1. Changes in patients population and characteristics of hematopoietic stem cell transplantation for relapsed/refractory Hodgkin lymphoma
- Author
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Sonja Genadieva Stavrik, Sascha Dietricht, Norbert Schmitz, Stephen D. Robinson, Peter Dreger, Anna Sureda, Alina Tanase, Irma Khvedelidze, Herve Finel, Olivier Hermine, Chara Kyriakou, Harry C. Schouten, Silvia Montoto, Ariane Boumendil, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Hematologie (9), and Interne Geneeskunde
- Subjects
Oncology ,Adult ,medicine.medical_specialty ,Allogeneic transplantation ,Transplantation Conditioning ,medicine.medical_treatment ,Population ,Hematopoietic stem cell transplantation ,prognostic-factors ,reduced-intensity ,Disease-Free Survival ,versus-host-disease ,03 medical and health sciences ,0302 clinical medicine ,HIGH-DOSE CHEMOTHERAPY ,BRENTUXIMAB VEDOTIN ,immune system diseases ,hemic and lymphatic diseases ,Internal medicine ,Refractory Hodgkin Lymphoma ,Medicine ,Humans ,education ,Brentuximab vedotin ,Transplantation ,education.field_of_study ,EUROPEAN GROUP ,business.industry ,Hematopoietic Stem Cell Transplantation ,Hematology ,blood progenitor-cell ,HAPLOIDENTICAL TRANSPLANTATION ,Total body irradiation ,medicine.disease ,Hodgkin Disease ,BONE-MARROW-TRANSPLANTATION ,Lymphoma ,surgical procedures, operative ,posttransplantation cyclophosphamide ,030220 oncology & carcinogenesis ,Stem cell ,Neoplasm Recurrence, Local ,business ,030215 immunology ,medicine.drug - Abstract
Indications for autologous (auto-HCT) and allogeneic transplantation (allo-HCT) in relapsed/refractory Hodgkin lymphoma (rrHL) have been long established. The expectation is that long-term outcomes have significantly improved over time with increased experience in these procedures. The objective of this study was to assess whether this is the case and to identify further areas of improvement. A total of 13,639 adult patients receiving an auto-HCT or allo-HCT for rrHL were reported to the European Society for Blood and Marrow Transplantation (EBMT) over a 25-year period. Regarding auto-HCT, recipients are younger, interval between diagnosis and transplant shorter, peripheral blood has become the universal stem cell source and the use of total body irradiation is almost non-existent in recent years. Allo-HCT is currently mostly used as a second transplant; recipients are younger, fitter and less frequently, chemorefractory. Reduced intensity conditioning protocols have vastly replaced myeloablative protocols. Increasing numbers of haplo-HCT have been reported. Both in auto-HCT and allo-HCT, NRM, PFS and OS have significantly improved but relapse remains the main cause of treatment failure. A better selection of patients and improvements in the supportive care has resulted in a reduction in the NRM. Relapse after HCT remains unchanged and further research is needed.
- Published
- 2020