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Non-Hodgkin's Lymphoma

Allogeneic peripheral blood stem cell transplantation for high-risk non-Hodgkin's lymphoma

Bone Marrow Transplantation volume 32, pages 763–769 (2003)Cite this article

Summary:

A high incidence of nonrelapse mortality (NRM) has limited the use of allogeneic transplantation for poor prognosis non-Hodgkin's lymphoma (NHL). We sought to improve the outcome of allografting by utilizing Filgrastim-mobilized peripheral blood stem cells (PBSC) in combination with either standard ablative or reduced-intensity conditioning. A total of 21 patients with intermediate/high-grade lymphoma and seven patients with low-grade histology were enrolled on protocols using PBSC. All patients were considered high risk for recurrence and/or NRM because of age >50 (n=16), refractory disease (n=17), failed autologous transplant (n=11) and abnormal organ function (n=2). In all, 17 patients received ablative regimens and 11 received modified conditioning including fludarabine, intravenous busulfan and ATG. Tacrolimus and mini-dose methotrexate were used for graft-versus-host-disease (GVHD) prophylaxis. Median follow-up was 38 months. Disease-free and overall survival were 57 and 58%. Seven of the 11 patients who relapsed after a previous transplant remain disease free. Four of the 10 patients with recurrent/persistent disease post transplant responded to additional therapy including withdrawal of immunosuppression±DLI. These results support a potent graft-versus-lymphoma effect and suggest that patients who relapse after an autologous transplant can be salvaged with an allogeneic transplant.

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Acknowledgements

We thank the dedicated coordinators, staff nurses and nurse practitioners involved in the daily care of these patients. In memory of G Lee. This work was supported in part by a grant from the Brian Rooney Fund of the Lymphoma Foundation.

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  1. Department of Internal Medicine, Section of Medical Oncology, Yale University School of Medicine, New Haven, CT, USA

    S Seropian, E Bahceci & D L Cooper

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  1. S Seropian
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  2. E Bahceci
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  3. D L Cooper
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Correspondence to S Seropian.

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Seropian, S., Bahceci, E. & Cooper, D. Allogeneic peripheral blood stem cell transplantation for high-risk non-Hodgkin's lymphoma. Bone Marrow Transplant 32, 763–769 (2003). https://doi.org/10.1038/sj.bmt.1704233

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