Non-Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation in Hodgkin's Disease

Introduction: Allogeneic hematopoietic stem cell transplantation (HSCT) is a potential curative treatment for relapsed Hodgkin’s Disease. Here we report the results from a single center institution.

Materials and Methods: A retrospective study was performed with 22 patients with Hodgkin’s Disease who underwent non-myeloablative allogeneic (NMA) HSCT in the period  October 1996 to June 2014 at The Bone Marrow Transplant Unit, Rigshospitalet, Copenhagen. All patients had previously received multiple regimens of chemotherapy, including HDT with autologous stem cell support, 7 patients had CR at the time of transplantation, others had stable disease/PR, Ann Arbor stage I-IV. The NMA conditioning regimens were : Fludarabine 90 mg/m² and TBI 2 Gy for 19 patients and the 3 patients who received umbilical cord blood (UCB) : Fludarabine 160 mg/m², Cyclofosfamide 50 mg/kg and TBI 2 Gy. There were 12 males and 10 females, median age 34.6 years, range 17 to 64.

 

Patients	Donor		CMV ab, patient		CMV ab, donor
	MUD	MRD	Pos	Neg	Pos	Neg
Female n=10	5	5	3	7	5	5
Male n=12	7	5	5	7	6	6

Results:

The overall survival rate was 29,7%, with a median observation time of 30 months, range 1 to 154 months.   Fourteen of 22 patients developed acute graft versus host disease grade 1 to 3 . Thirteen of 22 died, causes of death were: toxicity (n= 5), relapse/progressive disease (n= 6) and other malignancies (n= 2).    

Discussion: Despite a theoretical graft versus lymphoma effect has been discussed in Hodgkin’s Disease, this effect seems modest in our cohort. More efficient allogeneic transplant protocols are warranted for relapsed Hodgkin's disease.