Alternate donor hematopoietic cell transplantation (HCT) in non-Hodgkin lymphoma using lower intensity conditioning: a report from the CIBMTR. Biol Blood Marrow Transplant 2012 Jul;18(7):1036-1043.e1
Date
12/14/2011Pubmed ID
22155506Pubmed Central ID
PMC3894923DOI
10.1016/j.bbmt.2011.11.026Scopus ID
2-s2.0-84862130917 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
We analyzed the outcomes of 248 (61% male) adult recipients of HLA-matched unrelated and HLA-mismatched related donor hematopoietic cell transplantation (HCT) for non-Hodgkin lymphoma (NHL) after reduced or lower intensity conditioning (RIC), reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 1997 to 2004. Median age was 52 (range: 18-72 years); 31% had a Karnofsky performance score <90. Follicular NHL (43%) was the major histology. Incidence of grades II-IV acute graft-versus-host disease (aGVHD) was 43% at 100 days; and chronic GVHD (cGVHD) was 44% at 3 years. Treatment-related mortality (TRM) at 100 days was 24%. Three-year overall survival (OS) and progression-free survival (PFS) were 41% and 32%, respectively. In multivariate analysis, use of antithymocyte globulin (ATG) and HLA mismatch were associated with increased TRM. High-grade histology, ATG use, and chemotherapy resistance were associated with lower PFS. Older age, shorter interval from diagnosis to HCT, non-total body irridiation (TBI) conditioning regimens, ex vivo T cell depletion, and HLA-mismatched unrelated donors were associated with mortality. GVHD did not influence relapse or PFS. Older age, aggressive histology, and chemotherapy resistance correlated with poorer survival. For selected patients with NHL, lack of an available sibling donor should not be a barrier to allogeneic HCT.
Author List
Hale GA, Shrestha S, Le-Rademacher J, Burns LJ, Gibson J, Inwards DJ, Freytes CO, Bolwell BJ, Hsu JW, Slavin S, Isola L, Rizzieri DA, Gale RP, Laport GG, Montoto S, Lazarus HM, Hari PNAuthor
Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute DiseaseAdolescent
Adult
Aged
Antilymphocyte Serum
Chronic Disease
Female
Graft vs Host Disease
HLA Antigens
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Lymphocyte Depletion
Lymphoma, Non-Hodgkin
Male
Middle Aged
Registries
Survival Analysis
Transplantation Conditioning
Transplantation, Homologous
Unrelated Donors
Whole-Body Irradiation
