@article{966ffb4b8aae4fffaf1945d9eb878c5c,
title = "Outcome of Lower-Intensity Allogeneic Transplantation in Non-Hodgkin Lymphoma after Autologous Transplantation Failure",
abstract = "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.",
keywords = "Allogeneic, Reduced-intensity, Relapse",
author = "Freytes, {C{\'e}sar O.} and Zhang, {Mei Jie} and Jeanette Carreras and Burns, {Linda J.} and Gale, {Robert Peter} and Luis Isola and Perales, {Miguel Angel} and Matthew Seftel and Vose, {Julie M.} and Miller, {Alan M.} and John Gibson and Gross, {Thomas G.} and Rowlings, {Philip A.} and Inwards, {David J.} and Santiago Pavlovsky and Rodrigo Martino and Marks, {David I.} and Hale, {Gregory A.} and Smith, {Sonali M.} and Schouten, {Harry C.} and Simon Slavin and Klumpp, {Thomas R.} and Lazarus, {Hillard M.} and {van Besien}, Koen and Hari, {Parameswaran N.}",
note = "Funding Information: Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute, National Heart, Lung and Blood Institute, and National Institute of Allergy and Infectious Diseases ; Grant/Cooperative Agreement 5U01HL069294 from the National Cancer Institute and National Heart, Lung and Blood Institute ; Contract HHSH234200637015C with the Health Resources and Services Administration; Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research ; and grants from Allos, Amgen, Angioblast, anonymous donation to the Medical College of Wisconsin, Ariad, Be the Match Foundation, Blue Cross and Blue Shield Association, Buchanan Family Foundation, CaridianBCT, Celgene, CellGenix, Children{\textquoteright}s Leukemia Research Association, Fresenius-Biotech North America, Gamida Cell Teva Joint Venture, Genentech, Genzyme, GlaxoSmithKline, Kiadis Pharma, Leukemia and Lymphoma Society, Medical College of Wisconsin, Millennium Pharmaceuticals, Milliman USA, Miltenyi Biotec, National Marrow Donor Program, Optum Healthcare Solutions, Otsuka America Pharmaceutical, Seattle Genetics, Sigma-Tau Pharmaceuticals, Soligenix, Swedish Orphan Biovitrum, THERAKOS, and Wellpoint. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, Department of the Navy, Department of Defense, or any other agency of the US Government. The authors have no conflicts of interest to disclose. ",
year = "2012",
month = aug,
doi = "10.1016/j.bbmt.2011.12.581",
language = "English (US)",
volume = "18",
pages = "1255--1264",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
publisher = "Elsevier Inc.",
number = "8",
}