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A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma. Blood 2003 Apr 01;101(7):2476-82 PMID: 12456505

Pubmed ID

12456505

Abstract

Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%, P =.002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%, P =.05; and 34% versus 56%, P =.004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%, P =.82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%, P =.01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%, P =.09; 44% versus 39%, P =.47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.

Author List

Levine JE, Harris RE, Loberiza FR Jr, Armitage JO, Vose JM, Van Besien K, Lazarus HM, Horowitz MM, Bashey A, Bolwell BJ, Burns LJ, Cairo MS, Champlin RE, Freytes CO, Gibson J, Goldstein SC, Laughlin MJ, Lister J, Marks DI, Maziarz RT, Miller AM, Milone GA, Pavlovsky S, Pecora AL, Rizzo JD, Schiller G, Schouten HC, Zhang MJ, Lymphoma Study Writing Committee, International Bone Marrow Transplant Registry and Autologous Blood and Marrow Transplant Registry

Authors

Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
J. Douglas D. Rizzo MD, MS Director, Ctr Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-0038446692   107 Citations

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

Adolescent
Adult
Bone Marrow Transplantation
Child
Child, Preschool
Data Collection
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Recurrence
Retrospective Studies
Survival Rate
Transplantation, Autologous
Transplantation, Homologous
Transplantation, Isogeneic
Treatment Outcome
jenkins-FCD Prod-296 4db9d02597e0a2e889e230f853b641c12f1c3ee3