Non-myeloablative allogeneic haematopoietic cell transplantation for relapsed diffuse large B-cell lymphoma: a multicentre experience.

Abstract

Patients with relapsed diffuse large B-cell lymphoma (DLBCL) who have failed or are ineligible for autologous haematopoietic cell transplantation (HCT) have a poor prognosis. We examined the outcomes of non-myeloablative allogeneic HCT in this setting. Thirty-one patients with DLBCL and one patient with Burkitt lymphoma received allogeneic HCT following 2 Gy total body irradiation with or without fludarabine. Median age was 52 years. Twenty-four patients (75%) had undergone prior autologous HCT. Disease status at HCT was complete response (14/32, 44%), partial response (9/32, 28%), or refractory (9/32, 28%). Cumulative incidences of acute graft-versus-host disease (GVHD) grades II-IV, grades III-IV, and chronic GVHD were 53%, 19%, and 47% respectively. With a median follow-up of 45 months, 3-year estimated overall (OS) and progression-free survival (PFS) was 45% and 35% respectively. Three-year cumulative incidences of relapse and non-relapse mortality were 41% and 25% respectively. In multivariate models, chemosensitive disease and receipt of >or=4 lines of treatment before HCT were associated with better OS. Patients with chemosensitive disease had 3-year OS and PFS of 56% and 43% respectively. Non-myeloablative allogeneic HCT can produce long-term disease-free survival in patients with chemosensitive relapsed DLBCL who have failed or are ineligible for autologous HCT.

• Authors: Andrew R Rezvani, Lalitha Norasetthada, Ted Gooley, Mohamed Sorror, Michelle E Bouvier, Firoozeh Sahebi, Edward Agura, Thomas Chauncey, Richard T Maziarz, Michael Maris, Judith Shizuru, Benedetto Bruno, Christopher Bredeson, Thoralf Lange, Andrew Yeager, Brenda M Sandmaier, Rainer F Storb, David G Maloney
• Journal: British journal of haematology (Br J Haematol) Vol. 143 Issue 3 Pg. 395-403 (Nov 2008) ISSN: 1365-2141 [Electronic] England
• PMID: 18759762 (Publication Type: Evaluation Study, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)

Chemical References

• Immunosuppressive Agents

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Chronic Disease
• Epidemiologic Methods
• Female
• Graft Survival
• Graft vs Host Disease (etiology)
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Lymphoma, Large B-Cell, Diffuse (therapy)
• Male
• Middle Aged
• Recurrence
• Transplantation Conditioning (methods)
• Treatment Outcome
• Whole-Body Irradiation