Allogeneic hematopoietic cell transplantation for Hodgkin lymphoma: a concise review

Autologous hematopoietic cell transplantation (HCT) remains the standard of care for most patients with refractory or relapsed Hodgkin lymphoma (HL). However, the role of allogeneic HCT for this patient population is less defined. In retrospective analyses, allogeneic HCT with myeloablative conditioning confers lower relapse rates compared to autologous HCT but the higher nonrelapse mortality (NRM) offsets any survival benefit. This observed prohibitive NRM has thus fueled the increasing use of allogeneic HCT with reduced intensity conditioning (RIC) especially for patients who have failed a prior autologous HCT. Results with RIC allogeneic HCT appear promising with chemosensitive patients faring the best. Donor leukocyte infusions has been reported to induce durable remissions in relapsed HL patients even in patients who did not receive prior cytoreductive therapy which thus lends support to a graft versus HL effect.