title: Long-term outcomes after reduced-intensity conditioning allogeneic stem cell transplantation for low-grade lymphoma: a survey by the French Society of Bone Marrow Graft Transplantation and Cellular Therapy (SFGM-TC).
abstract: OBJECTIVE
  High-dose chemotherapy with allogeneic stem cell transplantation (SCT) has proven to be a successful treatment for low-grade lymphoma (LGL), but is associated with considerable transplant-related mortality (TRM). In an effort to reduce toxic mortality while maintaining the graft-versus-leukemia effect, allogeneic SCT has been combined with a reduced-intensity conditioning (RIC) regimen. The aim of this study was to determine the outcome of patients with LGL treated with RIC allogeneic SCT.
  
  
  METHODS
  This retrospective multicenter study included 73 patients with relapsed or refractory LGL allografted after a RIC regimen between 1998 and 2005 whose data were recorded in a French registry.
  
  
  RESULTS
  Patients received a median of three lines of therapy prior to RIC allogeneic SCT. The most widely used conditioning regimens were fludarabine + busulfan + antithymocyte globulin (n=43) and fludarabine + total body irradiation (n=21). Prior to allografting, patients were in complete response (CR; n=21), partial response (PR; n=33) or had chemoresistant disease (n=19). The median follow-up was 37 months (range, 16 to 77 months). In patients in CR, PR and chemoresistant disease, the 3-year overall survival rates were 66%, 64% and 32%, respectively, while the 3-year event-free survival rates were 66%, 52% and 32%, respectively. The 3-year cumulative incidences of TRM were 32%, 28% and 63%, respectively. The incidence of relapse was 9.6%.
  
  
  CONCLUSIONS
  Although associated with significant TRM, RIC allogeneic SCT in advanced chemosensitive disease leads to long-term survival.
authors.affiliation: Service d'Hématologie Clinique, Centre Hospitalier Universitaire (CHU) Pontchaillou, Rennes, France. vigouroux.st@wanadoo.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Vigouroux
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.forename: Raphaël
authors.initials: R
authors.lastname: Porcher
authors.forename: Michel
authors.initials: M
authors.lastname: Attal
authors.forename: Lionel
authors.initials: L
authors.lastname: Ades
authors.forename: Marc
authors.initials: M
authors.lastname: Bernard
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.forename: Reza
authors.initials: R
authors.lastname: Tabrizi
authors.forename: Frédéric
authors.initials: F
authors.lastname: Garban
authors.forename: Jill-Patrice
authors.initials: JP
authors.lastname: Cassuto
authors.forename: Patrice
authors.initials: P
authors.lastname: Chevalier
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.forename: Norbert
authors.initials: N
authors.lastname: Ifrah
authors.forename: Marc
authors.initials: M
authors.lastname: Renaud
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Vernant
authors.forename: Mathieu
authors.initials: M
authors.lastname: Kuentz
authors.forename: Jean-Henri
authors.initials: JH
authors.lastname: Bourhis
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordigoni
authors.forename: Eric
authors.initials: E
authors.lastname: Deconinck
authors.forename: Bruno
authors.initials: B
authors.lastname: Lioure
authors.forename: Gérard
authors.initials: G
authors.lastname: Socié
authors.forename: Noël
authors.initials: N
authors.lastname: Milpied
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002066:Busulfan / Q000008:administration & dosage; D002330:Carmustine / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003625:Data Collection; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005602:France; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology; D020544:Graft vs Leukemia Effect; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D015996:Survival Rate; D013601:T-Lymphocytes; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014916:Whole-Body Irradiation
chemical_list: D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D003561:Cytarabine; D005047:Etoposide; D003520:Cyclophosphamide; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine; D008558:Melphalan; D002330:Carmustine