Second autologous stem cell transplantation for relapsed lymphoma after a prior autologous transplant.
We determined treatment-related mortality, progression-free survival (PFS), and overall survival (OS) after a second autologous HCT (HCT2) for patients with lymphoma relapse after a prior HCT (HCT1). Outcomes for patients with either Hodgkin lymphoma (HL, n = 21) or non-Hodgkin lymphoma (NHL, n = 19) receiving HCT2 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) were analyzed. The median age at HCT2 was 38 years (range: 16-61) and 22 (58%) patients had a Karnofsky performance score <90. HCT2 was performed >1 year after HCT1 in 82%. The probability of treatment-related mortality at day 100 was 11% (95% confidence interval [CI], 3%-22%). The 1-, 3-, and 5-year probabilities of PFS were 50% (95% CI, 34%-66%), 36% (95% CI, 21%-52%), and 30% (95% CI, 16%-46%), respectively. Corresponding probabilities of survival were 65% (95% CI, 50%-79%), 36% (95% CI, 22%-52%), and 30% (95% CI, 17%-46%), respectively. At a median follow-up of 72 months (range: 12-124 months) after HCT2, 29 patients (73%) have died, 18 (62%) secondary to relapsed lymphoma. The outcomes of patients with HL and NHL were similar. In summary, this series represents the largest reported group of patients with relapsed lymphomas undergoing SCT2 following failed SCT1, and with long-term follow-up. Our series suggests that SCT2 is feasible in patients relapsing after prior HCT1, with a lower treatment-related mortality than that reported for allogeneic transplant in this setting. HCT2 should be considered for patients with relapsed HL or NHL after HCT1 without alternative allogeneic stem cell transplant options.
Smith
Sonali M
SM
Department of Medicine, The University of Chicago, Chicago, Illinois 60637, USA. smsmith@medicine.bsd.uchicago.edu
van Besien
Koen
K
Carreras
Jeanette
J
Bashey
Asad
A
Cairo
Mitchell S
MS
Freytes
Cesar O
CO
Gale
Robert Peter
RP
Hale
Gregory A
GA
Hayes-Lattin
Brandon
B
Holmberg
Leona A
LA
Keating
Armand
A
Maziarz
Richard T
RT
McCarthy
Philip L
PL
Navarro
Willis H
WH
Pavlovsky
Santiago
S
Schouten
Harry C
HC
Seftel
Matthew
M
Wiernik
Peter H
PH
Vose
Julie M
JM
Lazarus
Hillard M
HM
Hari
Parameswaran
P
D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy; D006801:Humans; D008223:Lymphoma / Q000401:mortality / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D016019:Survival Analysis; D014182:Transplantation, Autologous