A trial looking at high dose chemotherapy and stem cell transplants for people with Hodgkin lymphoma (PAIReD)

Cancer type:

Blood cancers
Hodgkin lymphoma
Lymphoma

Status:

Results

Phase:

Phase 2

This trial looked at sibling or unrelated donor stem cell transplants Open a glossary item for Hodgkin lymphoma. It was for people whose lymphoma:

  • had not disappeared completely after initial chemotherapy, or 
  • had come back and not fully responded to further treatment

The trial was supported by Cancer Research UK. It was open for people to join between 2010 and 2014. The team published the results in 2019.

More about this trial

The usual treatment for Hodgkin lymphoma (HL) that is not responding to treatment is high dose chemotherapy and a stem cell transplant

When this trial was done, people usually had a transplant using their own blood stem cells. These cells were collected when they had no signs of lymphoma. This is called an autologous transplant

Researchers thought it may be better for people to have a transplant using stem cells from a brother or sister, or from a donor who is not related to them. This is called an allogeneic transplant. They hoped it would reduce the chance of the lymphoma coming back. 

The main aim of this trial was to find out if sibling or other donor stem cell transplants are useful for people with Hodgkin lymphoma.

Summary of results

This trial showed that stem cell transplants using cells from other people could be useful for Hodgkin lymphoma that has not gone or has come back.

Results
A total of 31 people had a treatment as part of this trial. 

They all had high doses of chemotherapy to begin with. This is called conditioning. They had the drugs carmustine, etoposide, cytarabine, melphalan and alemtuzumab. We have information about most of these in our cancer drugs section.

They then had a stem cell transplant using cells from other people:

  • 11 people had a transplant using cells from their brother or sister
  • 20 people had a transplant using cells from a someone they weren’t related to  

By 3 years after treatment, the lymphoma had come back or got worse in 5 people (16%). Four of these people went on to have other treatment which worked well.

They also found that in total:

  • 25 people (81%) were living
  • the lymphoma had not got any worse in 21 of these 25 people (68%) 
  • 1 person (3%) died because their lymphoma had got worse
  • 5 people (16%) died because of other medical problems such as breathing problems or infections

These results are a bit better than you might see for people having a stem cell transplant using their own cells.

People taking part had a PET scan before treatment to see if their lymphoma was active or not. The transplant worked as well for those who had active lymphoma as those who didn’t. 

Side effects
One of the side effects of a stem cell transplant using cells from someone else is graft versus host disease (GvHD). This is where the immune system recognises the cells are not your own and attacks them. This causes problems such as diarrhoea, skin rashes and liver problems.

The team found that:

  • 4 people (13%) had moderate GvHD 
  • 2 people (7%) had severe GvHD
  • no one had very severe GvHD
  • 6 people (22%) had longer term GvHD

This is a bit lower than you might expect after a transplant using someone else’s stem cells.

Conclusion
The team concluded that these results were encouraging. And that a transplant using someone else’s stem cells could be used to treat some people with high risk Hodgkin lymphoma.

More detailed information
There is more information about this research in the reference below. 

Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.

Allo-HSCT in transplant-naïve patients with Hodgkin lymphoma: a single-arm, multicenter study
Emma Das-Gupta and others
Blood Advances, 2019. Volume 3, number 24, pages 4264 – 4270.

Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Karl Peggs

Supported by

Cancer Research UK
Chugai Pharma UK Ltd
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
University College London (UCL)

Other information

This is Cancer Research UK trial number CRUKE/09/005.

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

3357

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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