Non-myeloablative allogeneic haematopoietic cell transplantation for relapsed diffuse large B-cell lymphoma: a multicentre experience.

Publication Type:

Journal Article

Source:

British journal of haematology, Volume 143, Issue 3, p.395-403 (2008)

Keywords:

2008, Acute Disease, Adolescent, Adult, Aged, Center-Authored Paper, Chronic Disease, Clinical Research Division, Epidemiologic Methods, Female, Flow Cytometry Core Facility, Graft Survival, Graft vs Host Disease, hematopoietic stem cell transplantation, Humans, Immunosuppressive Agents, Lymphoma, Large B-Cell, Diffuse, Male, Middle Aged, RECURRENCE, Research Trials Office Core Facility - Biostatistics Service, Shared Resources, Transplantation Conditioning, Treatment Outcome, Whole-Body Irradiation

Abstract:

Patients with relapsed diffuse large B-cell lymphoma (DLBCL) who have failed or are ineligible for autologous haematopoietic cell transplantation (HCT) have a poor prognosis. We examined the outcomes of non-myeloablative allogeneic HCT in this setting. Thirty-one patients with DLBCL and one patient with Burkitt lymphoma received allogeneic HCT following 2 Gy total body irradiation with or without fludarabine. Median age was 52 years. Twenty-four patients (75%) had undergone prior autologous HCT. Disease status at HCT was complete response (14/32, 44%), partial response (9/32, 28%), or refractory (9/32, 28%). Cumulative incidences of acute graft-versus-host disease (GVHD) grades II-IV, grades III-IV, and chronic GVHD were 53%, 19%, and 47% respectively. With a median follow-up of 45 months, 3-year estimated overall (OS) and progression-free survival (PFS) was 45% and 35% respectively. Three-year cumulative incidences of relapse and non-relapse mortality were 41% and 25% respectively. In multivariate models, chemosensitive disease and receipt of >or=4 lines of treatment before HCT were associated with better OS. Patients with chemosensitive disease had 3-year OS and PFS of 56% and 43% respectively. Non-myeloablative allogeneic HCT can produce long-term disease-free survival in patients with chemosensitive relapsed DLBCL who have failed or are ineligible for autologous HCT.