Hematopoietic stem cell transplantation for refractory or recurrent non-Hodgkin lymphoma in children and adolescents.
We examined the role of hematopoietic stem cell transplantation (HSCT) for patients aged< or =18 years with refractory or recurrent Burkitt (n=41), lymphoblastic (n=53), diffuse large B cell (DLBCL; n=52), and anaplastic large cell lymphoma (n=36), receiving autologous (n=90) or allogeneic (n=92; 43 matched sibling and 49 unrelated donor) HSCT in 1990-2005. Risk factors affecting event-free survival (EFS) were evaluated using stratified Cox regression. Characteristics of allogeneic and autologous HSCT recipients were similar. Allogeneic donor HSCT was more likely to use irradiation-containing conditioning regimens, bone marrow (BM) stem cells, be performed in more recent years, and for lymphoblastic lymphoma. EFS rates were lower for patients not in complete remission at HSCT, regardless of donor type. After adjusting for disease status, 5-year EFS were similar after allogeneic and autologous HSCT for DLBCL (50% vs 52%), Burkitt (31% vs 27%), and anaplastic large cell lymphoma (46% vs 35%). However, EFS was higher for lymphoblastic lymphoma, after allogeneic HSCT (40% vs 4%; P < .01). Predictors of EFS for progressive or recurrent disease after HSCT included disease status at HSCT and use of allogeneic donor for lymphoblastic lymphoma. These data were unable to demonstrate a difference in outcome by donor type for the other histological subtypes.
Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, Ohio 43205, USA. thomas.gross@nationwidechildrens.org
Thomas G
TG
Gross
Gregory A
GA
Hale
Wensheng
W
He
Bruce M
BM
Camitta
Jean E
JE
Sanders
Mitchell S
MS
Cairo
Robert J
RJ
Hayashi
Amanda M
AM
Termuhlen
Mei-Jie
MJ
Zhang
Stella M
SM
Davies
Mary
M
Eapen
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D018450:Disease Progression; D046148:Donor Selection; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007223:Infant; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000517:prevention & control / Q000628:therapy*; D008297:Male; D012008:Recurrence; D012042:Registries; D012074:Remission Induction; D012307:Risk Factors; D016879:Salvage Therapy; D016019:Survival Analysis; D013997:Time Factors; D014182:Transplantation, Autologous / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome