High complete response rate after allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimens in advanced malignant lymphoma.
The possible advantage of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a graft-versus-lymphoma effect. We explored the feasibility and efficacy of allo-HSCT with reduced-intensity (RI) regimens in advanced malignant lymphoma (ML). A total of 20 patients with indolent (n=9) or aggressive lymphoma (n=11) received allo-HSCT with an RI regimen (RIST). The preparative regimen consisted of a combination of purine analog and alkylating agent with or without antithymocyte globulin. A total of 11 patients had chemorefractory disease, seven had chemosensitive relapsed disease and two had residual disease. All of the patients received G-CSF-mobilized blood stem cells from HLA-matched siblings. Of the 20 patients, 19 achieved engraftment with acceptable regimen-related toxicities. Seven patients developed grade II-IV acute GVHD and 15 developed chronic GVHD. Of the 15 patients with evaluable disease, 12 achieved a complete response. One died of invasive fusariosis, four subsequently died of GVHD complicated with fungal infection and one died of progressive disease. With a median follow-up of 358 days, the Kaplan-Meier estimates for 1-year overall and progression-free survival were both 70%. The high response rate with low relapse observed in this study suggests that RIST may be an effective alternative curative treatment for patients with advanced ML.
Tanimoto
T E
TE
Hematopoietic Stem Cell Transplant Unit, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Kusumi
E
E
Hamaki
T
T
Yuji
K
K
Ueyama
J
J
Miyakoshi
S
S
Morinaga
S
S
Kami
M
M
Kanda
Y
Y
Ando
T
T
Yoshihara
S
S
Masuo
S
S
Kim
S-W
SW
Nakai
K
K
Tobinai
K
K
Tanosaki
R
R
Mineishi
S
S
Takaue
Y
Y
Muto
Y
Y
D000328:Adult; D000477:Alkylating Agents / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011687:Purines / Q000627:therapeutic use; D012074:Remission Induction / Q000379:methods; D016879:Salvage Therapy / Q000379:methods; D016019:Survival Analysis; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000477:Alkylating Agents; D000961:Antilymphocyte Serum; D011687:Purines