The safety and efficacy of reduced-intensity conditioning (RIC) followed by allogeneic stem cell transplantation (SCT) for relapsed lymphomas remains unresolved. We conducted a prospective, multicentered, phase II trial. A total of 170 relapsed/refractory lymphomas received a RIC regimen followed by SCT from sibling donors. The primary study end point was non-relapse mortality (NRM). Histologies were non-Hodgkin's lymphomas (NHL) (indolent (LG-NHL), n=63; aggressive (HG-NHL), n=61; mantle cell lymphoma (MCL), n=14) and Hodgkin's disease (HD, n=32). Median follow-up was 33 months (range, 12-82). The results show that frequencies were as follows: cumulative NRM at 3 years, 14%; acute and chronic graft-versus-host disease (GVHD) 35 and 52%, respectively; 3-year overall survival (OS), 69% for LG-NHL, 69% for HG-NHL, 45% for MCL and 32% for HD (P=0.058); and 3-year relapse incidence, 29, 31, 35 and 81%, respectively (P<0.001). Relapse risk differed significantly at 3 years between follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL) (14 versus 46%, P=0.04). Molecular remission occurred in 94 and 40% (P=0.002) of patients with FL and CLL, respectively. On multivariate analysis, OS was influenced by chemorefractory disease (hazard ratio (HR)=3.6), diagnosis of HD (HR=3.5), and acute GVHD (HR=5.9). RIC allogeneic SCT is a feasible and effective salvage strategy in both indolent and aggressive NHL.
Allogeneic stem cell transplantation following reduced-intensity conditioning can induce durable clinical and molecular remissions in relapsed lymphomas : pre-transplant disease status and histotype heavily influence outcome / P. Corradini, A. Dodero, L. Farina, R. Fanin, F. Patriarca, R. Miceli, P. Matteucci, M. Bregni, R. Scimé, F. Narni, E. Pogliani, A. Locasciulli, R. Milani, C. Carniti, A. Bacigalupo, A. Rambaldi, F. Bonifazi, A. Olivieri, A.M. Gianni, C. Tarella. - In: LEUKEMIA. - ISSN 0887-6924. - 21:11(2007), pp. 2316-2323.
|Titolo:||Allogeneic stem cell transplantation following reduced-intensity conditioning can induce durable clinical and molecular remissions in relapsed lymphomas : pre-transplant disease status and histotype heavily influence outcome|
|Settore Scientifico Disciplinare:||Settore MED/15 - Malattie del Sangue|
Settore MED/06 - Oncologia Medica
|Data di pubblicazione:||2007|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1038/sj.leu.2404822|
|Appare nelle tipologie:||01 - Articolo su periodico|