title: Allogeneic haematopoietic stem cell transplantation in relapsed or refractory anaplastic large cell lymphoma of children and adolescents--a Berlin-Frankfurt-Münster group report.
abstract: Patients with refractory or early relapsed anaplastic large cell lymphoma (ALCL) have a poor chance of survival. We report 20 children and adolescents with high-risk relapsed or refractory ALCL who underwent allogeneic haematopoietic stem cell transplantation (HSCT). We retrospectively analysed 20 patients who relapsed between December 1991 and April 2003 during (six patients) or soon after first-line Berlin-Frankfurt-Münster-type chemotherapy (14 patients) and underwent allogeneic HSCT. Nine patients received allogeneic HSCT after the first relapse and 11 after multiple relapses. Eight patients received their transplants from matched sibling donors, eight from unrelated donors and four from haploidentical family donors. The conditioning regimen was based on total body irradiation in 15 patients. Two patients relapsed after allogeneic HSCT and died. Three patients died of transplant-related toxicity. Event-free survival at 3 years after allogeneic transplant was 75 +/- 10%. There was no influence of donor type or conditioning regimen on outcome. Two of six patients with progressive disease during frontline therapy survived compared with 13/14 patients with a first relapse after frontline therapy. Two of three patients who were transplanted with active lymphoma and all five patients who received allogeneic HSCT for relapse following autologous HSCT survived disease-free. Allogeneic HSCT is effective and has acceptable toxicity as rescue therapy for high-risk ALCL relapse. It even offers cure for patients refractory to chemotherapy, suggesting a graft-versus-ALCL effect.
authors.affiliation: Department of Paediatric Haematology and Oncology, Justus-Liebig-University, D-35392 Giessen, Germany.
authors.forename: Willi
authors.initials: W
authors.lastname: Woessmann
authors.forename: Christina
authors.initials: C
authors.lastname: Peters
authors.forename: Meike
authors.initials: M
authors.lastname: Lenhard
authors.forename: Birgit
authors.initials: B
authors.lastname: Burkhardt
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Sykora
authors.forename: Dagmar
authors.initials: D
authors.lastname: Dilloo
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kremens
authors.forename: Peter
authors.initials: P
authors.lastname: Lang
authors.forename: Monika
authors.initials: M
authors.lastname: Führer
authors.forename: Thomas
authors.initials: T
authors.lastname: Kühne
authors.forename: Reza
authors.initials: R
authors.lastname: Parwaresch
authors.forename: Wolfram
authors.initials: W
authors.lastname: Ebell
authors.forename: Alfred
authors.initials: A
authors.lastname: Reiter
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D004812:Epidemiologic Methods; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D012008:Recurrence; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome