Myeloablative allogeneic hematopoietic stem cell transplantation in patients who experience relapse after autologous stem cell transplantation for lymphoma: A report of the International Bone Marrow Transplant Registry

César O. Freytes, Fausto R. Loberiza, J. Douglas Rizzo, Asad Bashey, Christopher N. Bredeson, Mitchell S. Cairo, Robert Peter Gale, Mary M. Horowitz, Thomas R. Klumpp, Rodrigo Martino, Philip L. McCarthy, Arturo Molina, Santiago Pavlovsky, Andrew L. Pecora, Derek S. Serna, Tsuong Tsai, Mei Jie Zhang, Julie M. Vose, Hillard M. Lazarus, Koen Van Besien

Research output: Contribution to journalArticlepeer-review

95 Scopus citations

Abstract

Myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) is increasingly used in patients with lymphoma who experience disease relapse after autologous hematopoietic stem cell transplantation (auto-HSCT) because the allograft is tumor free and may induce a graft-versus-tumor effect. We analyzed 114 patients treated with this approach from 1990 to 1999 to assess disease progression, progression-free survival (PFS), and overall survival (OS). Cumulative incidence of disease progression at 3 years was 52%, whereas treatment-related mortality was 22%, lower than previously reported. Three-year probabilities of OS and PFS were 33% and 25%, respectively. With prolonged follow-up, however, nearly all patients experienced disease progression, and 5-year probabilities were 24% and 5%, respectively. Complete remission at the time of allo-HSCT and use of total body irradiation (TBI) in patients with non-Hodgkin lymphoma (NHL) were associated with lower rates of disease progression and higher rates of OS. In summary, allo-HSCT is feasible for patients with lymphoma who have relapses after auto-HSCT and can result in prolonged survival for some, but it is usually not curative. Most likely to benefit are patients who have HLA-matched sibling donors, are in remission, and have good performance status.

Original languageEnglish (US)
Pages (from-to)3797-3803
Number of pages7
JournalBlood
Volume104
Issue number12
DOIs
StatePublished - Dec 1 2004

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Fingerprint Dive into the research topics of 'Myeloablative allogeneic hematopoietic stem cell transplantation in patients who experience relapse after autologous stem cell transplantation for lymphoma: A report of the International Bone Marrow Transplant Registry'. Together they form a unique fingerprint.

Cite this