title: Disease status is a more reliable predictive factor than histology in lymphoma patients after reduced-intensity conditioning regimen and allo-SCT.
abstract: We analyzed 113 patients with lymphoma who underwent allogeneic transplantation with reduced-intensity conditioning (allo-RIC) regimens at a single institution, from February 2001 through November 2009, searching for factors predictive of the outcome. At the time of transplantation, 60% of patients were in CR, 29% in PR and 11% had progressive or stable disease. At a median follow-up of 34 months (confidence interval (CI) 17-45), the 3-year OS and PFS were 59% (CI 48-68%) and 51% (CI 41-61%), respectively. The 100-day and 2-year nonrelapse mortalities (NRM) were 6% and 28% (CI 20-35%), respectively. Grade II-IV acute GVHD (aGVHD) incidence was 38%, and the global incidence of chronic GVHD was 33%. In univariate analysis, OS was influenced by disease status before allo-RIC; aGVHD negatively affected on survival. Similarly, PFS was influenced only by disease status. Histological subtype did not affect OS or PFS. We conclude that disease status at the time of transplantation significantly influences survival in patients receiving allo-RIC for lymphoma, whereas histological subtype does not. This reinforces the need to administer more effective debulking treatments to lymphoma patients, for optimal benefit of allogeneic immune recognition of minimal residual disease, independently from lymphoma histology.
authors.affiliation: Hematology Department, Transplantation Program, Institut Paoli Calmettes, Marseille, France. luca.castagna@humanitas.it
authors.forename: L
authors.initials: L
authors.lastname: Castagna
authors.forename: R
authors.initials: R
authors.lastname: Boubdallah
authors.forename: S
authors.initials: S
authors.lastname: Furst
authors.forename: D
authors.initials: D
authors.lastname: Coso
authors.forename: J
authors.initials: J
authors.lastname: El Cheikh
authors.forename: C
authors.initials: C
authors.lastname: Faucher
authors.forename: R
authors.initials: R
authors.lastname: Crocchiolo
authors.forename: A
authors.initials: A
authors.lastname: Granata
authors.forename: C
authors.initials: C
authors.lastname: Chabannon
authors.forename: C
authors.initials: C
authors.lastname: Lemarié
authors.forename: B
authors.initials: B
authors.lastname: Calmels
authors.forename: J M
authors.initials: JM
authors.lastname: Boher
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.forename: D
authors.initials: D
authors.lastname: Blaise
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008223:Lymphoma / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate; D019172:Transplantation Conditioning