- Title
- Outcome of lower-intensity allogeneic transplantation in non-Hodgkin lymphoma after autologous transplantation failure
- Creator
- Freytes, César O.; Zhang, Mei-Jie; Gibson, John; Gross, Thomas G.; Rowlings, Philip A.; Inwards, David J.; Pavlovsky, Santiago; Martino, Rodrigo; Marks, David I.; Hale, Gregory A.; Smith, Sonali M.; Schouten, Harry C.; Carreras, Jeanette; Burns, Linda J.; Gale, Robert Peter; Isola, Luis; Perales, Miguel-Angel; Seftel, Matthew; Vose, Julie M.; Miller, Alan M.
- Relation
- Biology of Blood and Marrow Transplantation Vol. 18, Issue 8, p. 1255-1264
- Publisher Link
- http://dx.doi.org/10.1016/j.bbmt.2011.12.581
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2012
- Description
- We studied the outcome of allogeneic hematopoietic stem cell transplantation after lower-intensity conditioning regimens (reduced-intensity conditioning and nonmyeloablative) in patients with non-Hodgkin lymphoma who relapsed after autologous hematopoietic stem cell transplantation. Nonrelapse mortality, lymphoma progression/relapse, progression-free survival (PFS), and overall survival were analyzed in 263 patients with non-Hodgkin lymphoma. All 263 patients had relapsed after a previous autologous hematopoietic stem cell transplantation and then had undergone allogeneic hematopoietic stem cell transplantation from a related (n = 26) or unrelated (n = 237) donor after reduced-intensity conditioning (n = 128) or nonmyeloablative (n = 135) and were reported to the Center for International Blood and Marrow Transplant Research between 1996 and 2006. The median follow-up of survivors was 68 months (range, 3-111 months). Three-year nonrelapse mortality was 44% (95% confidence interval [CI], 37%-50%). Lymphoma progression/relapse at 3 years was 35% (95% CI, 29%-41%). Three-year probabilities of PFS and overall survival were 21% (95% CI, 16%-27%) and 32% (95% CI, 27%-38%), respectively. Superior Karnofsky Performance Score, longer interval between transplantations, total body irradiation-based conditioning regimen, and lymphoma remission at transplantation were correlated with improved PFS. Allogeneic hematopoietic stem cell transplantation after lower-intensity conditioning is associated with significant nonrelapse mortality but can result in long-term PFS. We describe a quantitative risk model based on pretransplantation risk factors to identify those patients likely to benefit from this approach.
- Subject
- allogenic; relapse; reduced-intensity
- Identifier
- http://hdl.handle.net/1959.13/1340465
- Identifier
- uon:28486
- Identifier
- ISSN:1083-8791
- Rights
- © The Authors 2012. This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License https://creativecommons.org/licenses/by-nc-nd/4.0/.
- Language
- eng
- Full Text
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