Myeloablative allogeneic hematopoietic stem cell transplantation for non-Hodgkin lymphoma: a nationwide survey in Japan.
We retrospectively surveyed the data of 233 patients who underwent myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) for non-Hodgkin lymphoma (NHL). Donors were HLA-matched relatives in 154 patients (66%) or unrelated volunteers in 60 (26%). Ninety patients (39%) were in complete remission. One hundred ninety-three (83%) received a total body irradiation (TBI)-based regimen, and 40 (17%) received a non-TBI-based regimen. Acute graft-versus-host disease (GVHD) occurred in 155 (67%) of the 233 evaluable patients; grade II to IV in 90 (39%), and grade III to IV in 37 (16%). Treatment-related mortality (TRM) was observed in 98 patients (42%), and 68% of them were related to GVHD. In a multivariate analysis, chemoresistance, prior autograft, and chronic GVHD were identified as adverse prognostic factors for TRM. Relapse or progression of lymphoma was observed in 21%. The 2-year overall survival rates of the patients with indolent (n = 38), aggressive (n = 111), and lymphoblastic lymphoma (n = 84) were 57%, 42%, and 41%, respectively. In a multivariate analysis, chemoresistance, prior autograft, and prior radiotherapy were identified as adverse prognostic factors for overall survival. Although myeloablative allo-HSCT represents an effective therapeutic option for patients with NHL, more work is still needed to decrease TRM and relapse.
Kim
Sung-Won
SW
Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Tanimoto
Tetsuya E
TE
Hirabayashi
Noriyuki
N
Goto
Seiichi
S
Kami
Masahiro
M
Yoshioka
Satoshi
S
Uchida
Toshiki
T
Kishi
Kenji
K
Tanaka
Yuji
Y
Kohno
Akio
A
Kasai
Masaharu
M
Higuchi
Masakazu
M
Kasai
Masanobu
M
Mori
Shin-Ichiro
S
Fukuda
Takahiro
T
Izutsu
Koji
K
Sao
Hiroshi
H
Ishikawa
Takayuki
T
Ichinohe
Tatsuo
T
Takeuchi
Kengo
K
Tajima
Kinuko
K
Tanosaki
Ryuji
R
Harada
Mine
M
Taniguchi
Shuichi
S
Tobinai
Kensei
K
Hotta
Tomomitsu
T
Takaue
Yoichi
Y
D000208:Acute Disease; D000328:Adult; D018450:Disease Progression; D005260:Female; D006086:Graft vs Host Disease / Q000628:therapy; D006306:Health Surveys; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome