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Allogeneic Transplant

Reduced-intensity rituximab-BEAM-CAMPATH allogeneic haematopoietic stem cell transplantation for follicular lymphoma is feasible and induces durable molecular remissions

Bone Marrow Transplantation volume 31, pages 551–557 (2003)Cite this article

Summary:

The indolent non-Hodgkin's lymphomas are theoretically curable through allogeneic haematopoietic stem cell transplantation (allo-HSCT). The applicability of standard conditioning allo-HSCT is, however, restricted by its toxicity. Recently, reduced-intensity conditioning regimens have demonstrated efficacy with significantly reduced early morbidity and mortality. We examined the safety and efficacy of rituximab-BEAM-CAMPATH as reduced-intensity conditioning for allo-HSCT in follicular lymphomas. Minimal residual disease was assessed by polymerase chain reaction (PCR) for bcl-2/IgH translocations, and chimerism by X,Y-FISH or PCR amplification of short tandem repeat sequences. At a median follow-up of 521 days (371–719), four of five patients were alive and three were in complete molecular remission. Three patients required pre-emptive treatment for CMV reactivation. One succumbed to a perforated viscus and one had slowly progressive disease. A graft-versus-lymphoma effect was demonstrable and quantitative PCR for bcl-2/IgH may allow better accuracy in scheduling post-allograft rituximab and/or donor lymphocyte infusions. Although follow-up is short, reduced-intensity allo-HSCT with BEAM-CAMPATH conditioning appears to be safe, effective in inducing a molecular remission and is potentially curative. Further recruitment and much longer follow-up will be necessary to determine if this impacts favourably upon disease-free and overall survival.

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Acknowledgements

We acknowledge Dr O Landt, TIB MOLBIOL, Berlin for the design and synthesis of MBR2 and bcl-2 probe.

Dr A Ho was supported by an educational grant from Roche Pharmaceuticals.

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  1. Department of Haematological Medicine, Guy's, King's and St Thomas' School of Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS, UK

    A Y L Ho, S Devereux, G J Mufti & A Pagliuca

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Ho, A., Devereux, S., Mufti, G. et al. Reduced-intensity rituximab-BEAM-CAMPATH allogeneic haematopoietic stem cell transplantation for follicular lymphoma is feasible and induces durable molecular remissions. Bone Marrow Transplant 31, 551–557 (2003). https://doi.org/10.1038/sj.bmt.1703898

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