Hodgkinlymphoma (HL) is a curable disease; however, 10-20% of patientsexperience relapsed/refractory disease. While autologoushematopoietic cell transplantation(auto-HCT) remains standard, asubstantial proportion relapse, necessitating alternative strategies.Allogeneic HCT (allo-HCT) remains a potentially curative option andhere we emphasize the role of reduced-intensity conditioning (RIC) inHL. Inthis review, we compare the feasibility, efficacy, and safety ofmyeloablative conditioning (MAC) and RIC allo-HCT inrelapsed/refractory HL. Additionally, we describe the evolvinglandscape of transplantation in HL with the use of novel agents,especially immune checkpoint inhibitors, the role of alternativedonors especially for ethnic minorities, and evolving literature onthe role of post-transplant Cyclophosphamide (PTCy) in improvingoutcomes. Allo-HCTremains a potentially curative option for patients withrelapsed/refractory HL. RIC allo-HCT has emerged as the preferredplatform for most patients, offering a favorable balance betweenefficacy and tolerability by leveraging graft-versus-malignancy (GVM)effects while minimizing non-relapse mortality over myeloablativeconditioning. The use of ICI in the first line has significantlyaltered post-transplant outcomes by enhancing GVM effects but alsoincreasing the risk of graft-versus-host disease (GVHD). PTCy-basedprophylaxis and optimized donor selection now enable the safer use ofalternative donors without compromising outcomes.
Narvel et al. (Wed,) studied this question.