Haploidentical stem cell transplantation: Treatment option for patients with refractory or relapsed Hodgkin Lymphoma

This study examined a treatment for advanced Hodgkin lymphoma, haploidentical stem cell transplantation with post-infusion cyclophosphamide (haplo-HSCT). The authors concluded that the use of haplo-HSCT is a valid treatment option for patients with advanced Hodgkin lymphoma (HL). 

Hodgkin lymphoma is generally a curable disease. However, some patients do not respond to first-line therapies. For these patients, stem cell (immature blood cell) transplants have been successfully used as a treatment option. Stem cell transplantations require patients to be matched with a donor, ideally someone with a similar genetic background (like a sibling). Some patients cannot find an identical match. Haploidentical stem cell transplantation (haplo-HSCT) uses stem cells from a donor that is a 50% match. It is not clear whether this option is effective in advanced HL.

The current study examined the use of haplo-HSCT in patients with advanced HL. This records of  62 patients with refractory or relapsed HL were examined in this study. None of these patients were matched with an identical donor, so haploidentical donors were used. All patients received cyclophosphamide (Cytoxan) after transplantation to reduce the risk of graft versus host disease (a condition where the transplanted cells begin to attack the healthy cells of the patient). Patients were followed for an average of 32 months.

16% of patients experienced chronic graft versus host disease. The 3-year overall survival rate (time from treatment until death from any cause) was 63% for the entire group of patients. 59% of patients were free from disease progression after 3 years. 21% of patients relapsed during the follow-up period. Patients who had stable HL (not progressive) at the time of haplo-HSCT had better overall survival outcomes than patients with progressive disease.

This study concluded that for patients with refractory or relapsed Hodgkin lymphoma who cannot find an identical stem cell donor, haploidentical stem cell transplantation may be a good treatment option.