Alemtuzumab-BEAM as conditioning for allogeneic hematopoietic stem cell transplantation in relapsed/refractory Hodgkin lymphoma: a single-center analysis

• Published in: Journal of cancer research and clinical oncology Vol. 142; no. 6; pp. 1307 - 1314
• Main Authors: Rabitsch, W., Bojic, M., Wohlfarth, P., Leiner, M., Schörgenhofer, C., Kalhs, P., Schulenburg, A., Sillaber, C., Mitterbauer, M., Sperr, W. R., Jäger, U., Skrabs, K., Greinix, H., Hermann, A., Lamm, W.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2016; Springer Nature B.V
• Subjects: Adult; Alemtuzumab; Analysis; Antibodies, Monoclonal, Humanized - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Cancer Research; Cancer therapies; Carmustine - administration & dosage; Cytarabine - administration & dosage; Etoposide - administration & dosage; Female; Graft vs Host Disease; Hematology; Hodgkin Disease - drug therapy; Hodgkin Disease - therapy; Humans; Internal Medicine; Lymphoma; Male; Medicine; Medicine & Public Health; Melphalan - administration & dosage; Oncology; Original Article – Clinical Oncology; Original – Clinical Oncology; Recurrence; Stem cells; Transplantation Conditioning; Transplants & implants; Young Adult; Allogeneic HSCT; Alemtuzumab-BEAM; Hodgkin lymphoma
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-016-2134-3

Purpose
Treatment of refractory Hodgkin disease deserves specific considerations. Recently, alemtuzumab-BEAM has been introduced in allogeneic hematopoietic stem cell transplantation (HSCT) in these patients.
Methods
We retrospectively analyzed the outcome of 20 patients with relapsed/refractory Hodgkin’s lymphoma (HL) who received allogeneic HSCT following conditioning therapy with alemtuzumab-BEAM.
Results
Treatment-related toxicity was tolerable. Half of the patients (50 %) had infections. Of these, 50 % were found to have pneumonia or catheter-related infections. In 20 %, an oral mucositis was observed. Acute graft-versus-host disease (GvHD) (≥grade 2) was seen in three patients. Complete remission (CR) could be achieved in 17 patients (85 %), 2 patients had persistent Hodgkin disease, and 1 patient died from infection prior to CR evaluation. Median progression-free survival and overall survival were 17.9 and 67.5 months, respectively. From the 17 CR patients, 8 had a relapse after a median of 10 months. Notably, of the eight patients relapsing after HSCT, all patients received another salvage treatment and four patients are still alive, whereas the other four patients died due to further progress. Six out of the remaining nine patients are still in CR, whereas the other three died from chronic GvHD and multi-organ failure. Overall, seven patients experienced chronic GvHD.
Conclusion
In summary, alemtuzumab-BEAM is a well-tolerated conditioning therapy for allogeneic HSCT with high response rates in refractory HL.