title: High complete response rate after allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimens in advanced malignant lymphoma.
abstract: 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.
authors.affiliation: Hematopoietic Stem Cell Transplant Unit, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
authors.forename: T E
authors.initials: TE
authors.lastname: Tanimoto
authors.forename: E
authors.initials: E
authors.lastname: Kusumi
authors.forename: T
authors.initials: T
authors.lastname: Hamaki
authors.forename: K
authors.initials: K
authors.lastname: Yuji
authors.forename: J
authors.initials: J
authors.lastname: Ueyama
authors.forename: S
authors.initials: S
authors.lastname: Miyakoshi
authors.forename: S
authors.initials: S
authors.lastname: Morinaga
authors.forename: M
authors.initials: M
authors.lastname: Kami
authors.forename: Y
authors.initials: Y
authors.lastname: Kanda
authors.forename: T
authors.initials: T
authors.lastname: Ando
authors.forename: S
authors.initials: S
authors.lastname: Yoshihara
authors.forename: S
authors.initials: S
authors.lastname: Masuo
authors.forename: S-W
authors.initials: SW
authors.lastname: Kim
authors.forename: K
authors.initials: K
authors.lastname: Nakai
authors.forename: K
authors.initials: K
authors.lastname: Tobinai
authors.forename: R
authors.initials: R
authors.lastname: Tanosaki
authors.forename: S
authors.initials: S
authors.lastname: Mineishi
authors.forename: Y
authors.initials: Y
authors.lastname: Takaue
authors.forename: Y
authors.initials: Y
authors.lastname: Muto
mesh_terms: 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
chemical_list: D000477:Alkylating Agents; D000961:Antilymphocyte Serum; D011687:Purines