Second allo-SCT in patients with lymphoma relapse after a first allogeneic transplantation. A retrospective study of the EBMT Lymphoma Working Party.
The aim of this registry-based retrospective study was to analyze the outcome of second allogeneic hematopoietic SCT (alloHSCT_2) performed in patients with lymphoma who had relapsed after a first allogeneic transplant (alloHSCT_1). Patients ⩾18 years who had received an alloHSCT_2 for lymphoma relapse between 2000 and 2011 were eligible. One hundred and forty patients were identified. The diagnosis was Hodgkin lymphoma (HL) in 31%, diffuse large B-cell lymphoma in 14%, T-cell lymphoma in 12%, indolent lymphoma in 19%, mantle cell lymphoma in 16% and other lymphomas in 8% of the patients. The median interval from alloHSCT_1 to alloHSCT_2 was 19 (range 4-116) months. Disease status at alloHSCT_2 was chemosensitive in 46%, refractory in 43% and unknown in 11% of the patients. Three-year PFS, OS, relapse incidence and nonrelapse mortality were 19%, 29%, 58% and 23%, respectively. PFS and OS were significantly affected by refractory disease at alloHSCT_2 and a short interval between alloHSCT_1 and alloHSCT_2. Long-term PFS was observed across all lymphoma subsets except for aggressive B-cell lymphoma. In conclusion, alloHSCT_2 is feasible and can result in long-term disease control in patients with lymphoma recurrence after alloHSCT_1, in particular if relapse occurs late and is chemosensitive.
1] EBMT Lymphoma Working Party, Paris, France [2] Department of Medicine V, University of Heidelberg, Heidelberg, Germany.
K
K
Horstmann
EBMT Lymphoma Working Party, Paris, France.
A
A
Boumendil
Department of Medicine I, University of Freiburg, Freiburg, Germany.
J
J
Finke
EBMT Lymphoma Working Party, Paris, France.
H
H
Finel
Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
E
E
Kanfer
Programma di Trapianto Emopoietico, Azienda Ospedaliera Policlinico Vittorio Emanuele, Catania, Italy.
G
G
Milone
Center for Clinical Hematology, Nottingham University Hospital, Nottingham, UK.
N
N
Russell
Division of Hematology and Bone Marrow Transplantation, IRCCS San Martino, Genova, Italy.
A
A
Bacigalupo
1] Division of Hematology, Department of Medical Specialties, University Hospital, Geneva, Switzerland [2] Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Y
Y
Chalandon
Department of Hematology and Hemotherapy, HGU Gregorio Marañón, Madrid, Spain.
J L
JL
Diez-Martin
CHRU, Service des Maladies du Sang, Angers, France.
N
N
Ifrah
Hospital Universitario "Virgen de las Nieves", Granada, Spain.
M Jurado
MJ
Chacon
1] EBMT Lymphoma Working Party, Paris, France [2] Department of Medicine V, University of Heidelberg, Heidelberg, Germany.
P
P
Dreger
D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate