Allogeneic stem cell transplantation using lymphoablative rather than myeloablative conditioning regimen for relapsed or refractory lymphomas. Issue 1 (18th March 2015)

• Record Type: Journal Article
• Authors: Yoon, Jae‐Ho; Jeon, Young‐Woo; Lee, Sung‐Eun; Cho, Byung‐Sik; Eom, Ki‐Seong; Kim, Yoo‐Jin; Lee, Seok; Kim, Hee‐Je; Min, Chang‐Ki; Lee, Jong‐Wook; Min, Woo‐Sung; Cho, Seok‐Goo
• Is Part Of: Hematological oncology. Volume 35:Issue 1(2017:Mar.)
• Page Start: 17
• Page End: 24
• Publication Date: 2015-03-18
• Subjects: non‐Hodgkin lymphoma -- allogeneic -- hematopoietic stem cell transplantation -- refractory -- relapse -- reduced intensity conditioning regimen; Hematological oncology -- Periodicals; Hematology; Medical Oncology; 616.99418005
• DOI: 10.1002/hon.2201
• Languages: English
• ISSNs: 0278-0232

Abstract

Abstract: In relapsed or refractory non‐Hodgkin lymphoma (NHL), allogeneic hematopoietic stem cell transplantation (allo‐HSCT) provides graft‐versus‐lymphoma activity resulting in fewer incidences of relapse. However, therapy‐related mortality (TRM) remains an important challenge. We attempted to introduce our reduced‐intensity conditioning (RIC) regimen. From 2007 to 2013, we treated 28 relapsed or refractory NHLs with allo‐HSCT. All were pre‐conditioned with fludarabine [FLU, 180 mg/body surface area (BSA)/6 days] and melphalan (MEL, 70 mg/BSA/1 day); 25 (all but 3) were additionally treated with total body irradiation (TBI, 800 cGy/4Fx/2 days). Peripheral blood stem cells were collected from matched siblings ( n = 10) or suitably matched unrelated ( n = 18) donors. There were eight diffuse large B‐cell lymphomas, seven peripheral T‐cell lymphoma not otherwise specified, give lymphoblastic lymphomas, two mantle cell lymphomas, and six various other lymphomas. Of these patients, 10 relapsed after auto‐HSCT, 5 relapsed after chemotherapy, and 13 were refractory lymphomas. After allo‐HSCT, complete remission was achieved in 22 (78.5%) patients. After a median follow‐up of 24.8 months, 3‐year overall survival and disease‐free survival were 62.4 and 59.2% and the 3‐year TRM and relapse incidence were 14.9 and 28.6% respectively. Acute and chronic graft‐versus‐host diseases (GVHDs) were identified in 17 (≥Grade II in 12 patients) and 18 patients respectively, and the group with chronic GVHD showed favourable survival outcomes. In relapsed or refractory NHL, RIC‐allo‐HSCT using FLU + MEL + 800 cGy TBI showed favourable survival outcomes with acceptable TRM and relapse incidence. Copyright © 2015 John Wiley & Sons, Ltd.