Allogeneic or autologous stem cell transplantation (SCT) for relapsed and refractory Hodgkin's disease and non-Hodgkin's lymphoma: a single-centre experience.
OBJECTIVE
The aim of the study was to evaluate which patient might benefit most from allogeneic stem cell transplantation (SCT) in the treatment of relapsed and/or refractory lymphoma.


METHODS
Thirty-eight consecutive lymphoma patients receiving either autologous (n = 24) or allogeneic (n = 14) stem cell grafts at our institution from 1986 to 1998 were retrospectively analysed regarding overall survival (OS), disease-free survival (DFS), transplant-related mortality (TRM), and relapse incidence (RI). Uni- and multivariate analyses were performed to identify patient characteristics predictive for outcome after SCT.


RESULTS
The probabilities of OS, DFS, TRM, and relapse were 57%, 51%, 29%, and 30% following autologous and 43%, 43%, 29%, and 38% following allogeneic SCT. Disease status (sensitive versus refractory) and the time interval between diagnosis and SCT were the most powerful predictive parameters for OS and TRM, whereas elevated serum LDH levels were signifcant in determining relapse.


CONCLUSIONS
In patients with elevated serum LDH levels and bone marrow involvement at the time of transplantation allogeneic was superior to autologous SCT and resulted in better outcome due to a lower relapse incidence strongly suggesting the existence of a graft-versus-lymphoma effect.
Nachbaur
D
D
Department of Internal Medicine, University Hospital, Innsbruck, Austria. david.nachbaur@uibk.ac.at
Oberaigner
W
W
Fritsch
E
E
Nussbaumer
W
W
Gastl
G
G
D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D014408:Biomarkers, Tumor / Q000097:blood; D001853:Bone Marrow / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D006087:Graft vs Host Reaction; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000097:blood / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D015993:Life Tables; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D007770:L-Lactate Dehydrogenase