Long-term disease-free survival of patients with advanced follicular lymphoma after allogeneic bone marrow transplantation.
Myeloablative allogeneic bone marrow transplantation (BMT) may be curative in patients with follicular non-Hodgkin's lymphoma, however, the impact of this therapy on long-term survival, disease progression and functional status is less clear. Twenty-nine patients (median age 42 years, range: 20-53) with advanced stage follicular lymphoma proceeded to allogeneic BMT a median of 25 (range: 8-154) months postdiagnosis, between 1985 and 2001, and have been followed for a minimum of 2 years. Eleven of 29 (38%) had refractory disease (n = 5 induction failure, n = 6 resistant relapse). Most (27 of 29, 93%) received total body irradiation-based conditioning; stem cell source was marrow from a related donor (n = 20) or unrelated donor (n = 9). Seventeen of 29 patients (59%) were alive a median of 5 years (range: 2-11) post-BMT with a median Karnofsky Performance Score of 100%. Death occurred because of transplant complications in seven patients (cumulative incidence of non-relapse mortality 24%), and progressive lymphoma in five patients (cumulative incidence of refractory/recurrent lymphoma 23%). The 5-year probability of overall and event-free survival was 58% and 53% respectively. Allogeneic BMT has resulted in long-term disease-free survival for approximately 50% of this cohort of patients with advanced follicular lymphoma and most of them now enjoy robust health.
Toze
Cynthia L
CL
Division of Hematology, Leukemia/BMT Program of British Columbia, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada. ctoze@bccancer.bc.ca
Barnett
Michael J
MJ
Connors
Joseph M
JM
Gascoyne
Randy D
RD
Voss
Nicholas J
NJ
Nantel
Stephen H
SH
Nevill
Thomas J
TJ
Shepherd
John D
JD
Sutherland
Heather J
HJ
Lavoie
Julye C
JC
Forrest
Donna L
DL
Song
Kevin W
KW
Hogge
Donna E
DE
D000328:Adult; D016026:Bone Marrow Transplantation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation