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-upwas 33 months (range, 12–82). The results show that frequencieswere as follows: cumulative NRM at 3 years, 14%; acuteand 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-yearrelapse incidence, 29, 31, 35 and 81%, respectively (P<0.001).Relapse risk differed significantly at 3 years between follicularlymphoma (FL) and chronic lymphocytic leukemia (CLL) (14versus 46%, P=0.04). Molecular remission occurred in 94 and40% (P=0.002) of patients with FL and CLL, respectively. Onmultivariate analysis, OS was influenced by chemorefractorydisease (hazard ratio (HR)=3.6), diagnosis of HD (HR=3.5),and acute GVHD (HR=5.9). RIC allogeneic SCT is a feasible andeffective 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., Scime; Narni, Franco; 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. - STAMPA. - 21:11(2007), pp. 2316-2323. [10.1038/sj.leu.2404822]
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
NARNI, Franco;
2007
Abstract
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-upwas 33 months (range, 12–82). The results show that frequencieswere as follows: cumulative NRM at 3 years, 14%; acuteand 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-yearrelapse incidence, 29, 31, 35 and 81%, respectively (P<0.001).Relapse risk differed significantly at 3 years between follicularlymphoma (FL) and chronic lymphocytic leukemia (CLL) (14versus 46%, P=0.04). Molecular remission occurred in 94 and40% (P=0.002) of patients with FL and CLL, respectively. Onmultivariate analysis, OS was influenced by chemorefractorydisease (hazard ratio (HR)=3.6), diagnosis of HD (HR=3.5),and acute GVHD (HR=5.9). RIC allogeneic SCT is a feasible andeffective salvage strategy in both indolent and aggressive NHL.Pubblicazioni consigliate
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