High complete response rate after allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimens in advanced malignant lymphoma

Bone Marrow Transplant. 2003 Jul;32(2):131-7. doi: 10.1038/sj.bmt.1704118.

Abstract

The possible advantage of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a graft-versus-lymphoma effect. We explored the feasibility and efficacy of allo-HSCT with reduced-intensity (RI) regimens in advanced malignant lymphoma (ML). A total of 20 patients with indolent (n=9) or aggressive lymphoma (n=11) received allo-HSCT with an RI regimen (RIST). The preparative regimen consisted of a combination of purine analog and alkylating agent with or without antithymocyte globulin. A total of 11 patients had chemorefractory disease, seven had chemosensitive relapsed disease and two had residual disease. All of the patients received G-CSF-mobilized blood stem cells from HLA-matched siblings. Of the 20 patients, 19 achieved engraftment with acceptable regimen-related toxicities. Seven patients developed grade II-IV acute GVHD and 15 developed chronic GVHD. Of the 15 patients with evaluable disease, 12 achieved a complete response. One died of invasive fusariosis, four subsequently died of GVHD complicated with fungal infection and one died of progressive disease. With a median follow-up of 358 days, the Kaplan-Meier estimates for 1-year overall and progression-free survival were both 70%. The high response rate with low relapse observed in this study suggests that RIST may be an effective alternative curative treatment for patients with advanced ML.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Alkylating Agents / therapeutic use
  • Antilymphocyte Serum / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Feasibility Studies
  • Female
  • Humans
  • Lymphoma / complications
  • Lymphoma / mortality
  • Lymphoma / therapy*
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation / adverse effects
  • Peripheral Blood Stem Cell Transplantation / methods*
  • Peripheral Blood Stem Cell Transplantation / mortality
  • Purines / therapeutic use
  • Remission Induction / methods
  • Salvage Therapy / methods
  • Survival Analysis
  • Transplantation Chimera
  • Transplantation Conditioning / adverse effects
  • Transplantation Conditioning / methods*
  • Transplantation Conditioning / mortality
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • Alkylating Agents
  • Antilymphocyte Serum
  • Purines