Faculty Collaboration Database

Allogeneic bone marrow transplantation for low-grade lymphoma. Blood 1998 Sep 01;92(5):1832-6

Date

08/26/1998

Pubmed ID

9716615

Scopus ID

2-s2.0-0032170122 (requires institutional sign-in at Scopus site)   240 Citations

Abstract

Advanced low-grade lymphomas are usually incurable with conventional-dose chemotherapy. It is uncertain whether cures are possible with high-dose therapy and bone marrow transplant from a human leukocyte antigen (HLA)-identical sibling. We sought to determine the outcome of HLA-identical sibling bone marrow transplants in advanced low-grade lymphoma in an observational study of 113 patients conducted at 50 centers participating in the International Bone Marrow Transplant Registry (IBMTR). The median patient age was 38 years (range, 15 to 61). Eighty percent had stage IV disease at the time of transplantation. The median number of prior chemotherapy regimens was two (range, 0 to 5). Thirty-eight percent had refractory disease and 29% a Karnofsky performance score (KPS) less than 80%. All patients underwent allogeneic bone marrow transplantation from a HLA-identical sibling donor. The conditioning regimen included total-body irradiation (TBI) in 82% of patients; cyclosporine was used for graft-versus-host disease prophylaxis in 74%. Survival, disease-free survival, recurrence rate, treatment-related mortality, and causes of death were determined. Three-year probabilities of recurrence, survival, and disease-free survival were 16% (95% confidence interval [CI], 9% to 27%), 49% (95% CI, 39% to 60%), and 49% (95% CI, 39% to 59%), respectively. Higher survival was associated with pretransplant KPS >/=90%, chemotherapy-sensitive disease, use of a TBI-containing conditioning regimen, and age less than 40 years. We conclude that high-dose therapy followed by transplantation from a HLA-identical sibling leads to prolonged survival in some patients with advanced low-grade lymphoma. Most mortality is treatment-related, and recurrences are rare.

Author List

van Besien K, Sobocinski KA, Rowlings PA, Murphy SC, Armitage JO, Bishop MR, Chaekal OK, Gale RP, Klein JP, Lazarus HM, McCarthy PL Jr, Raemaekers JM, Reiffers J, Phillips GL, Schattenberg AV, Verdonck LF, Vose JM, Horowitz MM

Author

Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of Wisconsin

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

Adolescent
Adult
Bone Marrow Transplantation
Cause of Death
Disease-Free Survival
Female
HLA Antigens
Humans
Leukemia, Lymphocytic, Chronic, B-Cell
Lymphoma, Follicular
Lymphoma, Non-Hodgkin
Male
Middle Aged
Neoplasm Staging
Nuclear Family
Recurrence
Registries
Survival Rate
Transplantation, Homologous