title: Reduced-intensity conditioning allogeneic stem cell transplant for relapsed or transformed aggressive B-cell non-Hodgkin lymphoma.
abstract: The role of reduced-intensity conditioning allogeneic stem cell transplant (RIC allo-SCT) in aggressive B-cell non-Hodgkin lymphoma (NHL) remains a matter of debate. This single-center analysis aimed to assess the potential benefit of RIC allo-SCT in 19 consecutive patients with relapsed or transformed aggressive B-cell NHL. Aggressive transformation (primary or secondary) was documented for these patients by pathological examination. In this series, all patients but two (n = 17; 89.5%) could actually receive autologous stem cell transplant (auto-SCT) prior to RIC allo-SCT. At the time of allo-SCT, eight patients (42%) were in first complete remission (CR), six (31.5%) were beyond first CR, and five (26.5%) were in partial remission. With a median follow-up of 32 (range, 3-86) months, nine patients experienced grade 2-4 acute GVHD (47.5%) and 10 patients had extensive chronic GVHD (52.5%). Overall, the incidence of non-relapse mortality was 26% (95% CI, 8-44%). At last follow-up, 12 patients (63%) were in sustained CR. The Kaplan-Meier estimates of progression-free and overall survival rates were 68% and 68%, respectively, at 4 years. We conclude that RIC allo-SCT after auto-SCT is feasible and a potentially efficient therapy for relapsed or transformed aggressive B-cell NHL, warranting further prospective evaluation.
authors.affiliation: Service d'Hématologie Clinique, Centre Hospitalier et Universitaire (CHU) de Nantes, Nantes, France.
authors.forename: Aline
authors.initials: A
authors.lastname: Clavert
authors.forename: Steven
authors.initials: S
authors.lastname: Le Gouill
authors.forename: Eolia
authors.initials: E
authors.lastname: Brissot
authors.forename: Viviane
authors.initials: V
authors.lastname: Dubruille
authors.forename: Beatrice
authors.initials: B
authors.lastname: Mahe
authors.forename: Thomas
authors.initials: T
authors.lastname: Gastinne
authors.forename: Nicolas
authors.initials: N
authors.lastname: Blin
authors.forename: Patrice
authors.initials: P
authors.lastname: Chevallier
authors.forename: Thierry
authors.initials: T
authors.lastname: Guillaume
authors.forename: Jacques
authors.initials: J
authors.lastname: Delaunay
authors.forename: Sameh
authors.initials: S
authors.lastname: Ayari
authors.forename: Beatrice
authors.initials: B
authors.lastname: Saulquin
authors.forename: Anne
authors.initials: A
authors.lastname: Moreau
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Noel
authors.initials: N
authors.lastname: Milpied
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D033581:Stem Cell Transplantation; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome