Real-World Outcomes of Autologous and Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Hodgkin Lymphoma in the Era of Novel Therapies: A Canadian Perspective

Olivier Veilleux, Jean Sébastien Claveau, Habiba Alaoui, Yasmina Serroukh, Jean Roy, Imran Ahmad, Jean Sébastien Delisle, Thomas Kiss, Nadia M. Bambace, Léa Bernard, Sandra Cohen, Guy Sauvageau, Isabelle Fleury, Luigina Mollica, Denis Claude Roy, Sylvie Lachance*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Despite high cure rates with frontline therapy for Hodgkin lymphoma (HL), approximately 30% of patients will relapse or develop primary refractory disease (R/r). Autologous hematopoietic stem cell transplantation (autoHSCT) is the standard of care for R/r disease, and allogeneic HSCT (alloHSCT) is a curative option for patients in second relapse. Novel agents are being incorporated for the treatment of R/r HL, such that the optimal timing of transplantation is currently being challenged. In this rapidly evolving field, we sought to offer a Canadian perspective on the optreatment of R/r HL and demonstrate the role and effectiveness of both autoHSCT and alloHSCT for the treatment of R/r HL. This single-center retrospective study examined outcomes in 89 consecutive patients with R/r HL treated with autoHSCT between January 2007 and December 2019. A total of 17 patients underwent alloHSCT either as a tandem auto-allo approach or as salvage therapy. With a median follow-up of 5.0 years, the estimated 5-year PFS and OS for patients undergoing autoHSCT were 57.5% (95% confidence interval [CI], 45.2% to 68.0%) and 81.3% (95% CI, 70.0% to 88.8%), respectively. Corresponding values for patients who underwent alloHSCT were 76.5% (95% CI, 48.8% to 90.4%) and 82.4% (95% CI, 54.7% to 93.9%). Nonrelapse mortality at 0% at 100 days and 9.4% at 5 years post-autoHSCT and 0% and 5.9%, respectively, post-alloHSCT. The cumulative incidence of acute graft-versus-host disease (GVHD) at day +100 was 35.3% (95% CI, 17.7% to 62.3%), and that of chronic GVHD at 1 year was 23.5% (95% CI, 6.9% to 45.8%). Both autoHSCT and alloHSCT provide robust and prolonged disease control New agents should be used as a bridge to improve the curative potential of these definitive cellular therapies.

Original languageEnglish
Pages (from-to)145-151
Number of pages7
JournalTransplantation and Cellular Therapy
Volume28
Issue number3
DOIs
Publication statusPublished - Mar 2022

Bibliographical note

ACKNOWLEDGMENTS
The authors gratefully acknowledge the referring physicians from centers across the Province of Quebec and staff of the Hôpital Maisonneuve-Rosemont (HMR) HSCT Program who participated in this study.

Publisher Copyright:
© 2021 The American Society for Transplantation and Cellular Therapy

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