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Reduced Intensity Conditioning

Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin’s lymphoma

Bone Marrow Transplantation volume 49, pages 190–194 (2014)Cite this article

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Abstract

Twenty-six patients with advanced Hodgkin’s disease received a related HLA haploidentical unmanipulated BMT, following a non-myeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose post-transplantation CY (PT-CY), mycophenolate and a calcineurin inhibitor. All patients had received a previous autograft, and 65% had active disease at the time of BMT. Sustained engraftment of donor cells occurred in 25 patients (96%), with a median time to neutrophil recovery (>0.5 × 109/L) and platelet recovery (>20 × 109/L) of +18 and +23 days from BMT. The incidence of grade II–IV acute GVHD and of chronic GVHD was 24% and 8%, respectively. With a median follow-up of 24 months (range 18–44) 21 patients are alive, 20 disease free. The cumulative incidence of TRM and relapse was 4% and 31%, respectively. The actuarial 3-year survival is 77%, the actuarial 3-year PFS is 63%. In conclusion, we confirm that high-dose PT-CY is effective as prophylaxis of GVHD after HLA haploidentical BMT, can prevent rejection and does not appear to eliminate the allogeneic graft versus lymphoma effect.

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Acknowledgements

This work was partly supported by the ‘Associazione Italiana Ricerca contro il Cancro’ (A.I.R.C.) Milano, Italy; Fondi Finalizzati, Ministero Salute, Italia; FARITMO Genova, Italy; and CARIGE Genova, Italy.

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Authors and Affiliations

  1. Divisione Ematologia e Trapianto di Midollo Osseo, IRCCS San Martino—IST, Genova, Italy

    A Raiola, A Dominietto, R Varaldo, A Ghiso, F Galaverna, M Clavio & A Bacigalupo

  2. Bone Marrow Transplantation Unit, Milano, Italy

    S Bramanti, E Todisco, B Sarina, A Ibatici, A Santoro & L Castagna

  3. Statistical Unit, Istituto Clinico Humanitas, Milano, Italy

    L Giordano

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  1. A Raiola
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Correspondence to A Raiola.

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Raiola, A., Dominietto, A., Varaldo, R. et al. Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin’s lymphoma. Bone Marrow Transplant 49, 190–194 (2014). https://doi.org/10.1038/bmt.2013.166

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