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Outcome of Haploidentical Stem Cell Transplantation in Patients with Lymphoma

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Haploidentical Stem Cell Transplantation

Part of the book series: Stem Cell Biology and Regenerative Medicine ((STEMCELL))

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Abstract

In this chapter we will review the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for both non Hodgkin (NHL) and Hodgkin lymphoma (HL), from the initial disappointing results reported in the first studies to the time where the landscape was changed with the introduction of reduced intensity conditioning protocols. Allo-HSCT is usually considered in patients failing a prior autologous stem cell transplantation (auto-HSCT as this latter transplant modality allows a long-term progression free survival (PFS) of at least 30% of patients with chemosensitive disease and it is associated to a low non-relapse mortality (NRM), as opposed to allo-HSCT. The activity reported in EBMT database throughout the years shows the increasing role of allo-HSCT for these diseases, and donor type has evolved from HLA identical sibling (SIB) to unrelated and haploidentical donor (HAPLO). This latter one has been a revolutionary field in the last decade for all hematological malignancies but in a particular way for lymphoid malignancies, mainly in the setting of T cell repleted graft together with cyclophosphamide-based post-HSCT immunosuppression. Although historically long-term outcome has been associated to donor type, with HLA-matched related grafts having superior outcomes to unrelated and HLA-haploidentical grafts, recent comparative studies from registries have shown that haploidentical donor may achieve at least equivalent overall outcomes than others, in terms of overall survival, PFS, relapse and NRM. Relapse and non graft versus host disease (GVHD) or infectious complications is the main cause of transplant failure and the nowadays challenge is to find new strategies to improve the graft versus lymphoma (GVL) effect in the haploidentical transplant field.

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Authors and Affiliations

  1. Institut Catalá d’Oncologia, Hospital Duran i Reynals, Barcelona, Spain

    Rocío Parody MD, PhD & Anna Sureda MD, PhD

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  1. Rocío Parody MD, PhD
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  2. Anna Sureda MD, PhD
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Correspondence to Rocío Parody MD, PhD .

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  1. Department of Hematology, Ankara University Medical School, Sıhhiye, Ankara, Turkey

    Taner Demirer

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Parody, R., Sureda, A. (2017). Outcome of Haploidentical Stem Cell Transplantation in Patients with Lymphoma. In: Demirer, T. (eds) Haploidentical Stem Cell Transplantation. Stem Cell Biology and Regenerative Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-65319-8_9

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