title: Allogeneic hematopoietic cell transplantation as curative therapy for non-transformed follicular lymphomas.
abstract: Allogeneic hematopoietic cell transplantation (HCT) offers the chance of cure for patients with non-transformed follicular lymphoma (FL), but is associated with the risk of non-relapse mortality (NRM). The aim of this study was to identify subgroups of FL patients who benefit from HCT. The European Society for Blood and Marrow Transplantation (EBMT) Minimum-Essential-A Data of 146 consecutive patients who received HCT for FL between 1998 and 2008 were extracted from the database of the German Registry 'DRST'. Diagnosis of FL was verified by contact with the reference pathologists. Estimated 1-, 2- and 5-year overall survivals (OS) were 67%, 60% and 53%, respectively. Day 100 NRM was 15%. Thirteen out of 33 patients (40%) with treatment-refractory disease (RD) at the time of transplantation survived long term. Univariate statistical analysis suggested limited chronic GvHD, donor age ⩽42 years and TBI-based conditioning in treatment refractory patients to correlate with favorable OS. Independent prognostic factors for OS were treatment-sensitive disease and limited chronic GvHD for the whole cohort, and additionally TBI-based conditioning for the treatment refractory subgroup. In contrast, patient age ⩾55 years had no impact on outcome. Thus, HCT for FL is associated with acceptable NRM, and offers a substantial chance of cure for patients with RD or advanced age. Donors ⩽42 years should be preferred if available.
authors: Department of Radiation Oncology, University Hospital (UH) of Tübingen, Tubingen, Germany.
authors: F
authors: F
authors: Heinzelmann
authors: Department of Internal Medicine II, UH of Tübingen, Tubingen, Germany.
authors: W
authors: W
authors: Bethge
authors: Department of Bone Marrow Transplantation, UH of Essen, Essen, Germany.
authors: D W
authors: DW
authors: Beelen
authors: Department of Radiotherapy, UH of Essen, Essen, Germany.
authors: M
authors: M
authors: Engelhard
authors: Clinic for Stem Cell Transplantation, UH of Hamburg (UKE), Hamburg, Germany.
authors: N
authors: N
authors: Kröger
authors: Department of Medicine V, UH of Heidelberg, Heidelberg, Germany.
authors: P
authors: P
authors: Dreger
authors: Department of Hematology and Oncology, UH of Leipzig, Leipzig, Germany.
authors: D
authors: D
authors: Niederwieser
authors: Department of Hematology and Oncology, UH of Freiburg, Freiburg, Germany.
authors: J
authors: J
authors: Finke
authors: Department of Internal Medicine III, UH of Ulm, Ulm, Germany.
authors: D
authors: D
authors: Bunjes
authors: Department of Internal Medicine III, UH of Munich (LMU), Munich, Germany.
authors: J
authors: J
authors: Tischer
authors: Department of Hematology, Oncology and Clinical Immunology, UH of Düsseldorf, Dusseldorf, Germany.
authors: G
authors: G
authors: Kobbe
authors: Department of Hematology and Oncology, UH of Regensburg, Regensburg, Germany.
authors: E
authors: E
authors: Holler
authors: Department of Internal Medicine I, UH of Dresden, Dresden, Germany.
authors: M
authors: M
authors: Bornhäuser
authors: Department of Internal Medicine A, UH of Münster, Munster, Germany.
authors: M
authors: M
authors: Stelljes
authors: Department for Bone Marrow Transplantation, DKD HELIOS Clinic of Wiesbaden, Wiesbaden, Germany.
authors: H
authors: H
authors: Baurmann
authors: Department of Radiation Oncology, University Hospital (UH) of Tübingen, Tubingen, Germany.
authors: A
authors: A
authors: Müller
authors: Data Processing Center, University of Würzburg, Wurzburg, Germany.
authors: I
authors: I
authors: Haubitz
authors: Institute of Clinical Transfusion Medicine and Immunogenetics, UH of Ulm, Ulm, Germany.
authors: H
authors: H
authors: Schrezenmeier
authors: ZKRD Ulm, Ulm, Germany.
authors: C
authors: C
authors: Müller
authors: Department of Bone Marrow Transplantation, UH of Essen, Essen, Germany.
authors: H
authors: H
authors: Ottinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005858:Germany; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D016879:Salvage Therapy / Q000379:methods; D015996:Survival Rate; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome; D014916:Whole-Body Irradiation; D055815:Young Adult