Myeloablative allogeneic hematopoietic stem cell transplantation in patients who experience relapse after autologous stem cell transplantation for lymphoma: A report of the International Bone Marrow Transplant Registry

César O. Freytes, Fausto R. Loberiza, J. Douglas Rizzo, Asad Bashey, Christopher N. Bredeson, Mitchell S. Cairo, Robert Peter Gale, Mary M. Horowitz, Thomas R. Klumpp, Rodrigo Martino, Philip L. McCarthy, Arturo Molina, Santiago Pavlovsky, Andrew L. Pecora, Derek S. Serna, Tsuong Tsai, Mei Jie Zhang, Julie M. Vose, Hillard M. Lazarus, Koen Van Besien

Research output: Contribution to journalArticle

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Abstract

Myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) is increasingly used in patients with lymphoma who experience disease relapse after autologous hematopoietic stem cell transplantation (auto-HSCT) because the allograft is tumor free and may induce a graft-versus-tumor effect. We analyzed 114 patients treated with this approach from 1990 to 1999 to assess disease progression, progression-free survival (PFS), and overall survival (OS). Cumulative incidence of disease progression at 3 years was 52%, whereas treatment-related mortality was 22%, lower than previously reported. Three-year probabilities of OS and PFS were 33% and 25%, respectively. With prolonged follow-up, however, nearly all patients experienced disease progression, and 5-year probabilities were 24% and 5%, respectively. Complete remission at the time of allo-HSCT and use of total body irradiation (TBI) in patients with non-Hodgkin lymphoma (NHL) were associated with lower rates of disease progression and higher rates of OS. In summary, allo-HSCT is feasible for patients with lymphoma who have relapses after auto-HSCT and can result in prolonged survival for some, but it is usually not curative. Most likely to benefit are patients who have HLA-matched sibling donors, are in remission, and have good performance status.

Original languageEnglish (US)
Pages (from-to)3797-3803
Number of pages7
JournalBlood
Volume104
Issue number12
DOIs
StatePublished - Dec 1 2004

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Transplants
Hematopoietic Stem Cell Transplantation
Stem Cell Transplantation
Stem cells
Registries
Lymphoma
Bone
Bone Marrow
Recurrence
Disease Progression
Tumors
Disease-Free Survival
Survival
Transplantation (surgical)
Grafts
Whole-Body Irradiation
Allografts
Non-Hodgkin's Lymphoma
Irradiation
Siblings

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Myeloablative allogeneic hematopoietic stem cell transplantation in patients who experience relapse after autologous stem cell transplantation for lymphoma : A report of the International Bone Marrow Transplant Registry. / Freytes, César O.; Loberiza, Fausto R.; Rizzo, J. Douglas; Bashey, Asad; Bredeson, Christopher N.; Cairo, Mitchell S.; Gale, Robert Peter; Horowitz, Mary M.; Klumpp, Thomas R.; Martino, Rodrigo; McCarthy, Philip L.; Molina, Arturo; Pavlovsky, Santiago; Pecora, Andrew L.; Serna, Derek S.; Tsai, Tsuong; Zhang, Mei Jie; Vose, Julie M.; Lazarus, Hillard M.; Van Besien, Koen.

In: Blood, Vol. 104, No. 12, 01.12.2004, p. 3797-3803.

Research output: Contribution to journalArticle

Freytes, CO, Loberiza, FR, Rizzo, JD, Bashey, A, Bredeson, CN, Cairo, MS, Gale, RP, Horowitz, MM, Klumpp, TR, Martino, R, McCarthy, PL, Molina, A, Pavlovsky, S, Pecora, AL, Serna, DS, Tsai, T, Zhang, MJ, Vose, JM, Lazarus, HM & Van Besien, K 2004, 'Myeloablative allogeneic hematopoietic stem cell transplantation in patients who experience relapse after autologous stem cell transplantation for lymphoma: A report of the International Bone Marrow Transplant Registry', Blood, vol. 104, no. 12, pp. 3797-3803. https://doi.org/10.1182/blood-2004-01-0231
Freytes, César O. ; Loberiza, Fausto R. ; Rizzo, J. Douglas ; Bashey, Asad ; Bredeson, Christopher N. ; Cairo, Mitchell S. ; Gale, Robert Peter ; Horowitz, Mary M. ; Klumpp, Thomas R. ; Martino, Rodrigo ; McCarthy, Philip L. ; Molina, Arturo ; Pavlovsky, Santiago ; Pecora, Andrew L. ; Serna, Derek S. ; Tsai, Tsuong ; Zhang, Mei Jie ; Vose, Julie M. ; Lazarus, Hillard M. ; Van Besien, Koen. / Myeloablative allogeneic hematopoietic stem cell transplantation in patients who experience relapse after autologous stem cell transplantation for lymphoma : A report of the International Bone Marrow Transplant Registry. In: Blood. 2004 ; Vol. 104, No. 12. pp. 3797-3803.
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abstract = "Myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) is increasingly used in patients with lymphoma who experience disease relapse after autologous hematopoietic stem cell transplantation (auto-HSCT) because the allograft is tumor free and may induce a graft-versus-tumor effect. We analyzed 114 patients treated with this approach from 1990 to 1999 to assess disease progression, progression-free survival (PFS), and overall survival (OS). Cumulative incidence of disease progression at 3 years was 52{\%}, whereas treatment-related mortality was 22{\%}, lower than previously reported. Three-year probabilities of OS and PFS were 33{\%} and 25{\%}, respectively. With prolonged follow-up, however, nearly all patients experienced disease progression, and 5-year probabilities were 24{\%} and 5{\%}, respectively. Complete remission at the time of allo-HSCT and use of total body irradiation (TBI) in patients with non-Hodgkin lymphoma (NHL) were associated with lower rates of disease progression and higher rates of OS. In summary, allo-HSCT is feasible for patients with lymphoma who have relapses after auto-HSCT and can result in prolonged survival for some, but it is usually not curative. Most likely to benefit are patients who have HLA-matched sibling donors, are in remission, and have good performance status.",
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AU - Freytes, César O.

AU - Loberiza, Fausto R.

AU - Rizzo, J. Douglas

AU - Bashey, Asad

AU - Bredeson, Christopher N.

AU - Cairo, Mitchell S.

AU - Gale, Robert Peter

AU - Horowitz, Mary M.

AU - Klumpp, Thomas R.

AU - Martino, Rodrigo

AU - McCarthy, Philip L.

AU - Molina, Arturo

AU - Pavlovsky, Santiago

AU - Pecora, Andrew L.

AU - Serna, Derek S.

AU - Tsai, Tsuong

AU - Zhang, Mei Jie

AU - Vose, Julie M.

AU - Lazarus, Hillard M.

AU - Van Besien, Koen

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N2 - Myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) is increasingly used in patients with lymphoma who experience disease relapse after autologous hematopoietic stem cell transplantation (auto-HSCT) because the allograft is tumor free and may induce a graft-versus-tumor effect. We analyzed 114 patients treated with this approach from 1990 to 1999 to assess disease progression, progression-free survival (PFS), and overall survival (OS). Cumulative incidence of disease progression at 3 years was 52%, whereas treatment-related mortality was 22%, lower than previously reported. Three-year probabilities of OS and PFS were 33% and 25%, respectively. With prolonged follow-up, however, nearly all patients experienced disease progression, and 5-year probabilities were 24% and 5%, respectively. Complete remission at the time of allo-HSCT and use of total body irradiation (TBI) in patients with non-Hodgkin lymphoma (NHL) were associated with lower rates of disease progression and higher rates of OS. In summary, allo-HSCT is feasible for patients with lymphoma who have relapses after auto-HSCT and can result in prolonged survival for some, but it is usually not curative. Most likely to benefit are patients who have HLA-matched sibling donors, are in remission, and have good performance status.

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