Faculty Collaboration Database

Outcome of BEAM-autologous and BEAM-alemtuzumab allogeneic transplantation in relapsed advanced stage follicular lymphoma. Br J Haematol 2008 Apr;141(2):235-43

Date

03/06/2008

Pubmed ID

18318762

DOI

10.1111/j.1365-2141.2008.07067.x

Scopus ID

2-s2.0-40949125732 (requires institutional sign-in at Scopus site)   41 Citations

Abstract

The role of haematopoietic stem cell transplantation (HSCT) in relapsed follicular lymphoma remains controversial. This study analysed 126 patients with relapsed, advanced stage follicular lymphoma who received BEAM (BCNU [carmustine], cytarabine, etoposide, melphalan)-alemtuzumab allogeneic HSCT (BEAM-allo) (n = 44) or BEAM-autologous HSCT (BEAM-auto) (n = 82). The BEAM-allo group had a younger median age (48 years vs. 56 years, P < 0.001) but received a higher median number of therapies pretransplant (P = 0.015) compared with the BEAM-auto group. There was a higher non-relapse mortality (NRM) in the BEAM-allo group compared with the BEAM-auto group at 1 year (20% vs. 2%, P = 0.001). Older age and heavily pretreated patients were associated with a higher NRM and poorer survival in the BEAM-allo group. There was, however, a significantly lower relapse rate (20% vs. 43%, P = 0.01) at 3 years with BEAM-alemtuzumab, with no relapses after 2 years, compared with a continued pattern of relapse in the autologous group. No difference in overall survival (OS) (P = 0.99) or disease-free survival (DFS) (P = 0.90) was identified at 3 years, whereas a plateau in OS and DFS with crossing of the survival curves in favour of BEAM-allo group was observed. Furthermore, the ability to re-induce remissions with donor leucocytes provides additional benefit in favour of allogeneic HSCT.

Author List

Ingram W, Devereux S, Das-Gupta EP, Russell NH, Haynes AP, Byrne JL, Shaw BE, McMillan A, Gonzalez J, Ho A, Mufti GJ, Pagliuca A

Author

Bronwen E. Shaw MBChB, PhD Center Director, Professor in the Medicine department at Medical College of Wisconsin

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

Acute Disease
Adult
Aged
Alemtuzumab
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antibodies, Neoplasm
Antineoplastic Combined Chemotherapy Protocols
Carmustine
Cytarabine
Etoposide
Female
Follow-Up Studies
Graft Survival
Graft vs Host Disease
Hematopoietic Stem Cell Mobilization
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Lymphoma, Follicular
Male
Melphalan
Middle Aged
Retrospective Studies
Transplantation Chimera
Transplantation Conditioning
Treatment Outcome