title: Ten-year follow-up of pediatric patients with non-Hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation.
abstract: BACKGROUND
  Autologous or allogeneic hematopoietic stem cell transplant (SCT) is often considered in patients with relapsed or refractory non-Hodgkin lymphoma (NHL) but there are limited data on the use of SCT for the treatment of NHL in the pediatric setting.
  
  
  METHODS
  To evaluate the role of SCT for children with NHL, we reviewed 36 consecutive pediatric patients with NHL who underwent an allogeneic (n = 21) or autologous (n = 15) SCT at our institution between 1982 and 2004. Pathologic classification included: lymphoblastic lymphoma (n = 12), Burkitt lymphoma (BL) (n = 5), diffuse large B-cell lymphoma (n = 4), anaplastic large cell lymphoma (ALCL) (n = 13), peripheral T cell lymphoma (n = 1), and undifferentiated NHL (n = 1). Donor source for allogeneic-SCT recipients was an HLA-matched related donor (n = 15), a matched unrelated donor (n = 4), or a mismatched donor (related n = 1; unrelated n = 1). Twenty-eight patients (78%) had chemotherapy responsive disease at the time of transplant (either CR or PR).
  
  
  RESULTS
  Overall survival (OS) and disease-free survival (DFS) were 55% and 53% with a median follow-up of 9.75 years. Outcomes were similar in patients receiving autologous and allogeneic-SCT (DFS 53% in both groups). Patients with ALCL had a DFS of 76.9%. In contrast, of five patients transplanted for BL, none survived. DFS among patients with chemotherapy sensitive disease was 61%, compared with 25% among patients with relapsed/refractory disease (P = 0.019).
  
  
  CONCLUSIONS
  Allogeneic and autologous SCT offer the prospect of durable, disease-free survival for a significant proportion of pediatric patients with relapsed or refractory NHL. Survival is superior among patients with chemotherapy sensitive disease.
authors.affiliation: Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York.
authors.forename: Lisa
authors.initials: L
authors.lastname: Giulino-Roth
authors.forename: Rosanna
authors.initials: R
authors.lastname: Ricafort
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Kernan
authors.forename: Trudy N
authors.initials: TN
authors.lastname: Small
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Trippett
authors.forename: Peter G
authors.initials: PG
authors.lastname: Steinherz
authors.forename: Susan E
authors.initials: SE
authors.lastname: Prockop
authors.forename: Andromachi
authors.initials: A
authors.lastname: Scaradavou
authors.forename: Michelle
authors.initials: M
authors.lastname: Chiu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Reilly
authors.forename: Farid
authors.initials: F
authors.lastname: Boulad
mesh_terms: D000293:Adolescent; D064592:Autografts; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy*; D008297:Male; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: allogeneic stem cell transplant; autologous stem cell transplant; non-Hodgkin lymphoma; pediatric