title: Allogeneic stem cell transplantation in patients with non-Hodgkin lymphoma who experienced relapse or progression after autologous stem cell transplantation.
abstract: There are few treatment options for patients with non-Hodgkin lymphoma (NHL) who experienced progression after high-dose chemotherapy (HDC) with autologous stem cell transplantation (auto-SCT). The role of allogeneic stem cell transplantation (allo-SCT) in these patients has not been clarified yet. In this study, we report clinical outcomes of allo-SCT in patients with NHL who experienced progression after HDC with auto-SCT. Patients were enrolled from seven hospitals in Korea. A total of 38 patients were included: 18 patients (47.4%) underwent myeloablative conditioning and 20 patients (52.6%) reduced intensity conditioning. Overall response rate was 73.3%. Median event-free survival was 6.3 months. Median overall survival (OS) was 19.0 months. Estimated 5-year survival rate was 35.0%. Acute graft-versus-host disease developed in 13 patients (34.2%). Transplant-related mortality (TRM) was 21.1% (eight patients). Ann Arbor stage (p=0.022), performance status (p<0.001), and baseline serum albumin level (p=0.010) were significant risk factors for OS. Performance status (p=0.022) was a significant risk factor for TRM. Eight patients with persistent or progressive disease received donor lymphocyte infusion, and two of them achieved complete remission. In conclusion, despite high TRM, allo-SCT is a viable option for patients with NHL who underwent progression after HDC with auto-SCT.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongro-gu, Seoul, 110-744, South Korea.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Byung-Su
authors.initials: BS
authors.lastname: Kim
authors.forename: Soo-Mee
authors.initials: SM
authors.lastname: Bang
authors.forename: Inho
authors.initials: I
authors.lastname: Kim
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Kim
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
authors.forename: Deok-Hwan
authors.initials: DH
authors.lastname: Yang
authors.forename: Je-Jung
authors.initials: JJ
authors.lastname: Lee
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Sang-Kyun
authors.initials: SK
authors.lastname: Sohn
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Yhim
authors.forename: Jae-Yong
authors.initials: JY
authors.lastname: Kwak
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Yoon
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Seonyang
authors.initials: S
authors.lastname: Park
authors.forename: Byoung Kook
authors.initials: BK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D005260:Female; D006801:Humans; D007723:Korea; D008228:Lymphoma, Non-Hodgkin / Q000503:physiopathology* / Q000517:prevention & control* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult