mini allo outcomes

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1: Leukemia. 2007 Nov;21(11):2316-23. Epub 2007

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.

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.

PMID: 17597807

Corradini P, Dodero A, Farina L, Fanin R, Patriarca F, Miceli R, Matteucci

P, Bregni M, Scimè R, Narni F, Pogliani E, Locasciulli A, Milani R, Carniti

C, Bacigalupo A, Rambaldi A, Bonifazi F, Olivieri A, Gianni AM, Tarella C;

Gruppo Italiano Trapianto di Midollo Osseo.

Division of Hematology and Bone Marrow Transplantation, Department of

Hematology, Istituto Nazionale per lo Studio e la Cura dei Tumori,

University of Milano, Milan, Italy.