Allogeneic bone marrow transplantation in patients with sensitive low-grade lymphoma or mantle cell lymphoma.
OBJECTIVE
To report survival outcomes of allogeneic BMT in patients with low-grade lymphoma or mantle cell lymphoma (MCL).


METHODS
Thirty-five patients with low-grade lymphoma (48%), chronic lymphocytic leukemia (26%), or MCL (26%) underwent myeloablative allogeneic BMT from HLA-identical siblings at the Johns Hopkins Oncology Center. Patients had a median age of 46 years, a median of 2 prior treatments, and 31% were in complete remission at the time of transplantation. The preparative regimen was cyclophosphamide/total body irradiation for most patients. All grafts were T-cell depleted by counter flow centrifugal elutriation with CD34+ augmentation.


RESULTS
The incidence of acute GVHD grade >2 was 6% and of grades 1 to 2 was 37%. The incidence of chronic GVHD was 6%. The median follow-up time was 25 months. The rate of event-free survival (EFS) was 50% (95% confidence interval [CI], 33%-66%). Only 1 patient relapsed. The transplantation-related mortality (TRM) was 46% for all patients. The TRM was 86% for patients with resistant disease and 14% for patients with sensitive disease and <2 prior treatments; rates of EFS were 0% (95% CI, 0%-0%) and 79% (95% CI, 47%-93%), respectively.


CONCLUSIONS
These data show that, with T-cell depletion, the TRM and relapse rates are modest for patients with sensitive disease and <2 prior treatment courses. Thus, if there is a role for allogeneic BMT in the management of patients with these tumors, it is early in the course of the disease.
Berdeja
J G
JG
Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA.
Jones
R J
RJ
Zahurak
M L
ML
Piantadosi
S
S
Abrams
R A
RA
Borowitz
M J
MJ
Vogelsang
G B
GB
Noga
S J
SJ
Ambinder
R F
RF
Flinn
I W
IW
D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods / Q000401:mortality*; D005260:Female; D006086:Graft vs Host Disease; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy; D008212:Lymphocyte Depletion; D020522:Lymphoma, Mantle-Cell / Q000401:mortality / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome