Purpose To compare the outcome of patients with Hodgkin lymphoma who received post-transplantation cyclophosphamide-based haploidentical (HAPLO) allogeneic hematopoietic cell transplantation with the outcome of patients who received conventional HLA-matched sibling donor (SIB) and HLA-matched unrelated donor (MUD). Patients and Methods We retrospectively evaluated 709 adult patients with Hodgkin lymphoma who were registered in the European Society for Blood and Marrow Transplantation database who received HAPLO (n = 98), SIB (n = 338), or MUD (n = 273) transplantation. Results Median follow-up of survivors was 29 months. No differences were observed between groups in the incidence of acute graft-versus-host disease (GVHD). HAPLO was associated with a lower risk of chronic GVHD (26%) compared with MUD (41%; P = .04). Cumulative incidence of nonrelapse mortality at 1 year was 17%, 13%, and 21% in HAPLO, SIB, and MUD, respectively, and corresponding 2-year cumulative incidence of relapse or progression was 39%, 49%, and 32%, respectively. On multivariable analysis, relative to SIB, nonrelapse mortality was similar in HAPLO ( P = .26) and higher in MUD ( P = .003), and risk of relapse was lower in both HAPLO ( P = .047) and MUD ( P < .001). Two-year overall survival and progression-free survival were 67% and 43% for HAPLO, 71% and 38% for SIB, and 62% and 45% for MUD, respectively. There were no significant differences in overall survival or progression-free survival between HAPLO and SIB or MUD. The rate of the composite end point of extensive chronic GVHD and relapse-free survival was significantly better for HAPLO (40%) compared with SIB (28%; P = .049) and similar to MUD (38%; P = .59). Conclusion Post-transplantation cyclophosphamide-based HAPLO transplantation results in similar survival outcomes compared with SIB and MUD, which confirms its suitability when no conventional donor is available. Our results also suggest that HAPLO results in a lower risk of chronic GVHD than MUD transplantation.

中文翻译：

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移植后基于环磷酰胺的单倍体移植替代匹配的兄弟姐妹或无关供者移植霍奇金淋巴瘤：欧洲血液和骨髓移植学会淋巴瘤工作组的一项登记研究

目的 比较接受基于环磷酰胺的半相合 (HAPLO) 异基因造血细胞移植的霍奇金淋巴瘤患者与接受传统 HLA 匹配同胞供体 (SIB) 和 HLA 匹配非亲缘供体 (MUD) 的患者的结果）。患者和方法 我们回顾性评估了 709 名在欧洲血液和骨髓移植学会数据库中注册并接受 HAPLO (n = 98)、SIB (n = 338) 或 MUD (n = 273) 移植的成年霍奇金淋巴瘤患者。结果幸存者的中位随访时间为 29 个月。在急性移植物抗宿主病 (GVHD) 的发生率方面，两组之间没有观察到差异。与 MUD (41%; P = .04) 相比，HAPLO 与慢性 GVHD (26%) 的风险较低相关。在 HAPLO、SIB 和 MUD 中，1 年非复发死亡率的累积发生率分别为 17%、13% 和 21%，相应的 2 年复发或进展累积发生率分别为 39%、49% 和 32%，分别。在多变量分析中，相对于 SIB，HAPLO ( P = .26) 和 MUD 的非复发死亡率相似 ( P = .003)， HAPLO ( P = .047) 和 MUD ( P < .001）。HAPLO 的两年总生存率和无进展生存率分别为 67% 和 43%，SIB 为 71% 和 38%，MUD 为 62% 和 45%。HAPLO 与 SIB 或 MUD 之间的总生存期或无进展生存期没有显着差异。与 SIB（28%；P = .00）相比，HAPLO（40%）的广泛慢性 GVHD 和无复发生存复合终点的发生率显着更好。049) 并且类似于 MUD (38%; P = .59)。结论 与 SIB 和 MUD 相比，移植后基于环磷酰胺的 HAPLO 移植的生存结果相似，这证实了它在没有常规供体可用的情况下的适用性。我们的结果还表明 HAPLO 导致慢性 GVHD 的风险低于 MUD 移植。