title: Second autologous stem cell transplantation for relapsed lymphoma after a prior autologous transplant.
abstract: 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.
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois 60637, USA. smsmith@medicine.bsd.uchicago.edu
authors.forename: Sonali M
authors.initials: SM
authors.lastname: Smith
authors.forename: Koen
authors.initials: K
authors.lastname: van Besien
authors.forename: Jeanette
authors.initials: J
authors.lastname: Carreras
authors.forename: Asad
authors.initials: A
authors.lastname: Bashey
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Cairo
authors.forename: Cesar O
authors.initials: CO
authors.lastname: Freytes
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hale
authors.forename: Brandon
authors.initials: B
authors.lastname: Hayes-Lattin
authors.forename: Leona A
authors.initials: LA
authors.lastname: Holmberg
authors.forename: Armand
authors.initials: A
authors.lastname: Keating
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.forename: Philip L
authors.initials: PL
authors.lastname: McCarthy
authors.forename: Willis H
authors.initials: WH
authors.lastname: Navarro
authors.forename: Santiago
authors.initials: S
authors.lastname: Pavlovsky
authors.forename: Harry C
authors.initials: HC
authors.lastname: Schouten
authors.forename: Matthew
authors.initials: M
authors.lastname: Seftel
authors.forename: Peter H
authors.initials: PH
authors.lastname: Wiernik
authors.forename: Julie M
authors.initials: JM
authors.lastname: Vose
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Hari
mesh_terms: 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