Outcomes after alemtuzumab-containing reduced-intensity allogeneic transplantation regimen for relapsed and refractory non-Hodgkin lymphoma
| Autor: | Kirsty Thomson, Graeme M. Smith, Steve Schey, David C. Linch, Charles Craddock, Emma C. Morris, Prem Mahendra, Anne Hunter, Donald Milligan, Jane Tighe, Karl S. Peggs, C Hatton, Gordon Cook, Stephen Mackinnon, Anthony H. Goldstone, Rajesh Chopra, Anne Parker |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Antibodies Neoplasm Chronic lymphocytic leukemia Immunology Graft vs Host Disease Antineoplastic Agents Antibodies Monoclonal Humanized Biochemistry Gastroenterology Donor lymphocyte infusion Refractory Non-Hodgkin Lymphoma Actuarial Analysis Recurrence immune system diseases hemic and lymphatic diseases Internal medicine Humans Medicine Alemtuzumab neoplasms Aged Bone Marrow Transplantation business.industry Lymphoma Non-Hodgkin Antibodies Monoclonal Cell Biology Hematology Middle Aged medicine.disease Combined Modality Therapy Survival Analysis Fludarabine Surgery Transplantation Treatment Outcome Graft-versus-host disease Female Mantle cell lymphoma business Stem Cell Transplantation medicine.drug |
| Zdroj: | Blood. 104:3865-3871 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | We report the outcomes after reduced-intensity conditioning allogeneic stem cell transplantation (RIT) for non-Hodgkin lymphoma (NHL) in 88 patients (low-grade NHL [LG-NHL], n = 41; high-grade NHL [HG-NHL], n = 37; mantle cell lymphoma [MCL], n = 10). Thirty-seven patients had previously received autografts, and 21 were in complete remission (CR) at transplantation. Conditioning therapy consisted of alemtuzumab, fludarabine, and melphalan. Sixty-five patients received peripheral blood stem cells (PBSCs) from HLA-identical siblings, and 23 received bone marrow (BM) from matched unrelated donors. Prophylaxis for graft-versus-host disease (GVHD) consisted of cyclosporin A. Grade III-IV acute GVHD developed in 4 patients, and chronic GVHD developed in 6 patients. With a median follow-up of 36 months (range, 18-60 months), the actuarial overall survival (OS) rates at 3 years were 34% for HG-NHL, 60% for MCL, and 73% for LG-NHL (P < .001). The 100-day and 3-year transplant-related mortality (TRM) rates for patients with LG-NHL were 2% and 11%, respectively, and were better (P = .01) than they were for patients with HG-NHL (27% and 38%, respectively). The actuarial current progression-free survival (PFS) rate at 3 years, including the rate for patients who achieved remission after donor lymphocyte infusion (DLI) for progression, was 65% for LG-NHL, 50% for MCL, and 34% for HG-NHL (P = .002). Twenty-one patients underwent DLI for matched related donor (MD)-persistent disease or relapse, and 15 underwent DLI for mixed hematopoietic chimerism. Patients who experienced relapses of LG-NHL and chronic lymphocytic leukemia (CLL) achieved excellent PFS with extremely low TRM and GVHD, even when matched related donors were unavailable. (Blood. 2004;104:3865-3871) |
| Databáze: | OpenAIRE |
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