In some patients in whom HDC fails, allogeneic HSC transplantation may be a viable option. In this method, myeloablative therapy (chemotherapy and sometimes RT) is followed by the infusion of HSCs from a genetically matched donor. This offers the potential for an immunological antitumor effect from T-cells provided by the HSC donor, which may improve the chances for cure of the disease. Historically, allogeneic transplantation for Hodgkin disease has been considered too high risk for most patients due a high transplant-related mortality. However, evolution of transplant protocols to include less toxic conditioning regimens, such as min-ablative approaches, will likely expand the utility of this option for patients with refractory Hodgkin disease. Allogeneic transplantation for Hodgkin is considered standard of care already at this time. For example, NCCN (HODG-12) lists it as a category 3 recommendation.
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