An oral session on lymphoma took place at the 44 thEuropean Society for Blood and Marrow Transplantation(EBMT) annual meeting on 19 March 2018. Abstract OS1-2was presented by Sarah Haebe, from the Department of Medicine III, Laboratory for Experimental Leukemia and Lymphoma Research, Ludwig-Maximilians University, Munich, Germany which compared the safety and efficacy of post-transplantation cyclophosphamide (PTCy)-based haploidentical donor (haplo-D) transplantation versus HLA-matched related donor (MRD) or unrelated donor (URD) transplantation in refractory or relapsed (R/R) aggressive non-Hodgkin lymphoma (aNHL).
In this study, patients treated with T-cell replete (TCR) HLA-haploidentical hematopoietic stem cell transplantation (haplo-HSCT) were matched-paired with patients receiving HLA-matched transplantation (MRD and URD). The age (± 5 years) and the stage at HSCT (defined as complete response [CR] or non-CR) varied between pair-matched patients in this analysis. The primary endpoints of this study were overall survival (OS), progression-free survival (PFS), non-relapse mortality (NRM) and graft-versus-host disease (GvHD) incidence.
Demographics
- N = 21 patients in each group (TCR/PTCy haplo-HSCT, MRD and URD)
- Successful match-pair single center analysis of 21 haplo-HSCT with 21 MRD and 21 URD patients
- Median age of all patients (range): 48 (20–65)
- Histology (all patients):
- Aggressive NHL: 62%
- Indolent NHL: 22%
- T-cell NHL (T-NHL): 16%
- Median number of prior therapies (range): 4 (2–6)
- Conditioning regimen (all patients):
- Reduced intensity conditioning (RIC): 58%
- Non-myeloablative conditioning(NMA): 21%
- Myeloablative conditioning (MAC): 21%
Key Findings
- Median follow-up: 39 months
- CR at Day +30 (all patients) = 84%;
- Median time to engraftment (days;
P= 0.2):
- MRD = 16
- URD = 18
- Haplo = 20
- PFS and OS at 2-years (%):
- MRD = 33 and 43
- URD = 19 and 38
- Haplo = 43 and 52
- PFS and OS at 3-years (%):
- MRD = 29 and 33
- URD = 19 and 38
- Haplo = 38 and 52
- Occurrence of acute GvHD II–IV at 100-days follow-up (%;
P= 0.03):
- MRD = 30
- URD = 55
- Haplo = 21
- Occurrence of chronic GvHD (moderate and severe) at one year follow-up (%;
P= 0.4):
- MRD = 39
- URD = 35
- Haplo = 20
- Non-relapse mortality (NRM) within one year after transplantation (%):
- MRD = 2
- URD = 33
- Haplo = 24
- Relapse rate within the first year after transplantation (%):
- MRD = 29
- URD = 38
- Haplo = 24
- Death from aplasia = 6 patients
The results from this study demonstrated similar outcomes between patients treated with haplo-HSCT using PTCy and patients who received HLA-matched transplantation. With a higher incidence of acute GvHD and NRM rates after URD transplantation, the authors suggested that haplo-HSCT might be used as an efficient safer alternative regimen for patients with aNHL.