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T cell-depleted allogeneic bone marrow transplantation for high-risk non-Hodgkin's lymphoma: clinical and molecular follow-up. Bone Marrow Transplant 1998 May;21(9):893-9 PMID: 9613781

Pubmed ID

9613781

Abstract

The use of allogeneic BMT in patients with relapsed non-Hodgkin lymphoma (NHL) offers the advantage of tumor-free bone marrow and possibly a 'graft-versus-lymphoma effect' which may decrease the risk of recurrence. However, allogeneic BMT also poses an increased risk of death due to graft-versus-host disease (GVHD) which can be ameliorated by T cell depletion. We performed a retrospective review of 37 patients who underwent T cell-depleted allogeneic BMT for aggressive and indolent NHL between 1988 and 1996. Polymerase chain reaction (PCR) was used to identify indolent NHL patients with the BCL2/IgH translocation which served as a marker of residual disease. Sixteen of 37 patients (44%) are alive and progression-free with a median follow-up of 4.4 years (range 1-10.3). The incidence of grade 2-4 acute GVHD was 36% and extensive chronic GVHD developed in 12%. Patients with aggressive NHL have an overall PFS of 33% (12-54%); those with chemotherapy-resistant and sensitive disease have PFS of 17% (0-47%), and 40% (15-65%) respectively at 5 years. Patients with indolent histologies have overall PFS of 62% (37-86%); those with chemotherapy-resistant and sensitive disease have PFS of 55% (25-85%) and 80% (45-100%) respectively at 5 years. Eight patients with indolent disease had a BCL2/IgH translocation detectable by PCR. Five of these eight patients remain alive and progression free at a median of 6.5 years after BMT (range 2.1-7.4 years), four of whom remain PCR positive from 1.7 to 2.9 years after transplantation. We conclude that T cell-depleted allogeneic BMT poses a low risk for death due to GVHD, and should be considered for patients with relapsed and refractory indolent NHL.

Author List

Juckett M, Rowlings P, Hessner M, Keever-Taylor C, Burns W, Camitta B, Casper J, Drobyski WR, Hanson G, Horowitz M, Lawton C, Margolis J, Peitryga D, Vesole D

Authors

Bruce M. Camitta MD Clinical Professor in the Medicine department at Medical College of Wisconsin
William R. Drobyski MD Professor in the Medicine department at Medical College of Wisconsin
Martin J. Hessner PhD Professor in the Pediatrics department at Medical College of Wisconsin
David A. Margolis MD Professor in the Pediatrics department at Medical College of Wisconsin




Scopus

2-s2.0-0031894170   48 Citations

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

Adolescent
Adult
Bone Marrow Transplantation
Child
Chromosomes, Human, Pair 14
Chromosomes, Human, Pair 18
Female
Genes, bcl-2
Graft vs Host Disease
Humans
Immunoglobulin Heavy Chains
Lymphocyte Depletion
Lymphoma, Non-Hodgkin
Male
Middle Aged
Polymerase Chain Reaction
Retrospective Studies
Survival Rate
T-Lymphocytes
Translocation, Genetic
Transplantation, Homologous
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e