A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma

John E. Levine, Richard E. Harris, Fausto R. Loberiza, James Olen Armitage, Julie Marie Vose, Koen Van Besien, Hillard M. Lazarus, Mary M. Horowitz

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%, P = .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%, P = .05; and 34% versus 56%, P = .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%, P = .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%, P= .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%, P= .09; 44% versus 39%, P = .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.

Original languageEnglish (US)
Pages (from-to)2476-2482
Number of pages7
JournalBlood
Volume101
Issue number7
DOIs
StatePublished - Apr 1 2003

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Autologous Transplantation
Stem cells
Bone Marrow Transplantation
Transplants
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Bone
Transplantation
Bone Marrow
Stem Cell Transplantation
Recurrence
Transplantation (surgical)
Survival
Registries
Stem Cells
Neurology
Mortality
Hematopoietic Stem Cell Transplantation
Blood
Siblings
Lymphoma

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma. / Levine, John E.; Harris, Richard E.; Loberiza, Fausto R.; Armitage, James Olen; Vose, Julie Marie; Van Besien, Koen; Lazarus, Hillard M.; Horowitz, Mary M.

In: Blood, Vol. 101, No. 7, 01.04.2003, p. 2476-2482.

Research output: Contribution to journalArticle

Levine, JE, Harris, RE, Loberiza, FR, Armitage, JO, Vose, JM, Van Besien, K, Lazarus, HM & Horowitz, MM 2003, 'A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma', Blood, vol. 101, no. 7, pp. 2476-2482. https://doi.org/10.1182/blood-2002-05-1483
Levine, John E. ; Harris, Richard E. ; Loberiza, Fausto R. ; Armitage, James Olen ; Vose, Julie Marie ; Van Besien, Koen ; Lazarus, Hillard M. ; Horowitz, Mary M. / A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma. In: Blood. 2003 ; Vol. 101, No. 7. pp. 2476-2482.
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abstract = "Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18{\%} versus 3{\%}, P = .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32{\%} versus 46{\%}, P = .05; and 34{\%} versus 56{\%}, P = .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36{\%} versus 39{\%}, P = .82). AutoSCT recipients had higher overall survival at 6 months (75{\%} versus 59{\%}, P= .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60{\%} versus 49{\%}, P= .09; 44{\%} versus 39{\%}, P = .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.",
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T1 - A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma

AU - Levine, John E.

AU - Harris, Richard E.

AU - Loberiza, Fausto R.

AU - Armitage, James Olen

AU - Vose, Julie Marie

AU - Van Besien, Koen

AU - Lazarus, Hillard M.

AU - Horowitz, Mary M.

PY - 2003/4/1

Y1 - 2003/4/1

N2 - Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%, P = .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%, P = .05; and 34% versus 56%, P = .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%, P = .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%, P= .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%, P= .09; 44% versus 39%, P = .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.

AB - Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%, P = .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%, P = .05; and 34% versus 56%, P = .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%, P = .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%, P= .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%, P= .09; 44% versus 39%, P = .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.

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