title: Myeloablative allogeneic hematopoietic stem cell transplantation for non-Hodgkin lymphoma: a nationwide survey in Japan.
abstract: 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.
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Tetsuya E
authors.initials: TE
authors.lastname: Tanimoto
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hirabayashi
authors.forename: Seiichi
authors.initials: S
authors.lastname: Goto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoshioka
authors.forename: Toshiki
authors.initials: T
authors.lastname: Uchida
authors.forename: Kenji
authors.initials: K
authors.lastname: Kishi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Akio
authors.initials: A
authors.lastname: Kohno
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kasai
authors.forename: Masakazu
authors.initials: M
authors.lastname: Higuchi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kasai
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.forename: Koji
authors.initials: K
authors.lastname: Izutsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sao
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ichinohe
authors.forename: Kengo
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Kinuko
authors.initials: K
authors.lastname: Tajima
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tanosaki
authors.forename: Mine
authors.initials: M
authors.lastname: Harada
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Kensei
authors.initials: K
authors.lastname: Tobinai
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Hotta
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Takaue
mesh_terms: 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