title: Nonablative allogeneic stem-cell transplantation for advanced/recurrent mantle-cell lymphoma.
abstract: OBJECTIVE
  Patients with relapsed mantle-cell lymphoma have poor prognosis and short survival. Our aim was to determine the efficacy of nonablative allogeneic stem-cell transplantation in patients with relapsed mantle-cell lymphoma.
  
  
  METHODS
  Eighteen patients were treated in one of two consecutive trials. Thirteen patients underwent a conditioning regimen of fludarabine (30 mg/m2 daily for 3 days), cyclophosphamide (750 mg/m2 daily for 3 days), and high-dose rituximab. For the remaining five patients, the conditioning regimen consisted of cisplatin (25 mg/m2 daily for 4 days), fludarabine (30 mg/m2 daily for 2 days), and cytarabine (1,000 mg/m2 daily for 2 days). Tacrolimus and methotrexate were used for graft-versus-host disease prophylaxis.
  
  
  RESULTS
  The median age was 56.5 years. Patients underwent a median of three prior chemotherapy regimens. Prior autologous transplantation failed in five (28%) patients and 16 (89%) had chemosensitive disease. Donor cell engraftment occurred in all patients. Eight patients (44%) required no platelet or RBC transfusion, and acute graft-versus-host disease of greater than grade 2 did not develop in any patient. The day-100 mortality was 0%. Complete remission (CR) occurred in 17 patients. Three patients progressed, and one was reinduced into continuous CR with donor lymphocyte infusion. With a median follow-up period of 26 months, the actuarial probability of current-event-free-survival at 3 years was 82% (95% CI, 65% to 99%).
  
  
  CONCLUSIONS
  Our data suggest that nonablative allogeneic transplantation is a safe and potentially effective strategy for patients with relapsed and chemosensitive mantle-cell lymphoma.
authors.affiliation: Department of Blood and Marrow Transplantation, Unit 423, the University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA. ikhouri@mdanderson.org
authors.forename: Issa F
authors.initials: IF
authors.lastname: Khouri
authors.forename: Ming-S
authors.initials: MS
authors.lastname: Lee
authors.forename: Rima M
authors.initials: RM
authors.lastname: Saliba
authors.forename: Gu
authors.initials: G
authors.lastname: Jun
authors.forename: Luis
authors.initials: L
authors.lastname: Fayad
authors.forename: Anas
authors.initials: A
authors.lastname: Younes
authors.forename: Barbara
authors.initials: B
authors.lastname: Pro
authors.forename: Sandra
authors.initials: S
authors.lastname: Acholonu
authors.forename: Peter
authors.initials: P
authors.lastname: McLaughlin
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Katz
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000517:prevention & control; D020350:Graft vs Tumor Effect; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020522:Lymphoma, Mantle-Cell / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D012074:Remission Induction; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus