Faculty Collaboration Database

Second autologous stem cell transplantation for relapsed lymphoma after a prior autologous transplant. Biol Blood Marrow Transplant 2008 Aug;14(8):904-12

Date

07/22/2008

Pubmed ID

18640574

Pubmed Central ID

PMC3353768

DOI

10.1016/j.bbmt.2008.05.021

Scopus ID

2-s2.0-47249135075 (requires institutional sign-in at Scopus site)   51 Citations

Abstract

We determined treatment-related mortality, progression-free survival (PFS), and overall survival (OS) after a second autologous HCT (HCT2) for patients with lymphoma relapse after a prior HCT (HCT1). Outcomes for patients with either Hodgkin lymphoma (HL, n = 21) or non-Hodgkin lymphoma (NHL, n = 19) receiving HCT2 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) were analyzed. The median age at HCT2 was 38 years (range: 16-61) and 22 (58%) patients had a Karnofsky performance score <90. HCT2 was performed >1 year after HCT1 in 82%. The probability of treatment-related mortality at day 100 was 11% (95% confidence interval [CI], 3%-22%). The 1-, 3-, and 5-year probabilities of PFS were 50% (95% CI, 34%-66%), 36% (95% CI, 21%-52%), and 30% (95% CI, 16%-46%), respectively. Corresponding probabilities of survival were 65% (95% CI, 50%-79%), 36% (95% CI, 22%-52%), and 30% (95% CI, 17%-46%), respectively. At a median follow-up of 72 months (range: 12-124 months) after HCT2, 29 patients (73%) have died, 18 (62%) secondary to relapsed lymphoma. The outcomes of patients with HL and NHL were similar. In summary, this series represents the largest reported group of patients with relapsed lymphomas undergoing SCT2 following failed SCT1, and with long-term follow-up. Our series suggests that SCT2 is feasible in patients relapsing after prior HCT1, with a lower treatment-related mortality than that reported for allogeneic transplant in this setting. HCT2 should be considered for patients with relapsed HL or NHL after HCT1 without alternative allogeneic stem cell transplant options.

Author List

Smith SM, van Besien K, Carreras J, Bashey A, Cairo MS, Freytes CO, Gale RP, Hale GA, Hayes-Lattin B, Holmberg LA, Keating A, Maziarz RT, McCarthy PL, Navarro WH, Pavlovsky S, Schouten HC, Seftel M, Wiernik PH, Vose JM, Lazarus HM, Hari P

Author

Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Feasibility Studies
Female
Hematopoietic Stem Cell Transplantation
Hodgkin Disease
Humans
Lymphoma
Lymphoma, Non-Hodgkin
Male
Middle Aged
Recurrence
Reoperation
Survival Analysis
Transplantation, Autologous