Abstract
The aim of this registry-based retrospective study was to analyze the outcome of second allogeneic hematopoietic SCT (alloHSCT_2) performed in patients with lymphoma who had relapsed after a first allogeneic transplant (alloHSCT_1). Patients ⩾18 years who had received an alloHSCT_2 for lymphoma relapse between 2000 and 2011 were eligible. One hundred and forty patients were identified. The diagnosis was Hodgkin lymphoma (HL) in 31%, diffuse large B-cell lymphoma in 14%, T-cell lymphoma in 12%, indolent lymphoma in 19%, mantle cell lymphoma in 16% and other lymphomas in 8% of the patients. The median interval from alloHSCT_1 to alloHSCT_2 was 19 (range 4–116) months. Disease status at alloHSCT_2 was chemosensitive in 46%, refractory in 43% and unknown in 11% of the patients. Three-year PFS, OS, relapse incidence and nonrelapse mortality were 19%, 29%, 58% and 23%, respectively. PFS and OS were significantly affected by refractory disease at alloHSCT_2 and a short interval between alloHSCT_1 and alloHSCT_2. Long-term PFS was observed across all lymphoma subsets except for aggressive B-cell lymphoma. In conclusion, alloHSCT_2 is feasible and can result in long-term disease control in patients with lymphoma recurrence after alloHSCT_1, in particular if relapse occurs late and is chemosensitive.
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References
Sureda A, Canals C, Arranz R, Caballero D, Ribera JM, Brune M et al. Allogeneic stem cell transplantation after reduced intensityconditioning in patients with relapsed or refractory Hodgkin'slymphoma. Results of the HDR-ALLO study—a prospectiveclinical trial by the Grupo Espanol de Linfomas/ Trasplante deMedula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Haematologica 2012; 97: 310–317.
van Kampen RJ, Canals C, Schouten HC, Nagler A, Thomson KJ, Vernant JP et al. Allogeneic stem-cell transplantation as salvage therapy for patients with diffuse large B-Cell Non-Hodgkin's lymphoma relapsing after an autologous stem-cell transplantation: An analysis of the European Group for Blood and Marrow Transplantation Registry. J Clin Oncol 2011; 29: 1342–1348.
Glass B, Hasenkamp J, Wulf G, Dreger P, Pfreundschuh M, Gramatzki M et al. Rituximab after lymphoma-directed conditioning and allogeneic stem-cell transplantation for relapsed and refractory aggressive non-Hodgkin lymphoma (DSHNHL R3): an open-label, randomised, phase 2 trial. Lancet Oncol 2014; 15: 757–766.
Tam CS, Bassett R, Ledesma C, Korbling M, Alousi A, Hosing C et al. Mature results of the MD Anderson Cancer Center risk-adapted transplantation strategy in mantle cell lymphoma. Blood 2009; 113: 4144–4452.
Thomson KJ, Morris EC, Milligan D, Parker AN, Hunter AE, Cook G et al. T-cell-depleted reduced-intensity transplantation followed by donor leukocyte infusions to promote graft-versus-lymphoma activity results in excellent long-term survival in patients with multiply relapsed follicular lymphoma. J Clin Oncol 2010; 28: 3695–3700.
Dodero A, Spina F, Narni F, Patriarca F, Cavattoni I, Benedetti F et al. Allogeneic transplantation following a reduced-intensity conditioning regimen in relapsed/refractory peripheral T-cell lymphomas: long-term remissions and response to donor lymphocyte infusions support the role of a graft-versus-lymphoma effect. Leukemia 2012; 26: 520–526.
Koenigsmann M, Casper J, Kahl C, Basara N, Sayer HG, Behre G et al. Risk-adapted, treosulfan-based therapy with auto- and allo-SCT for relapsed/refractory aggressive NHL: a prospective phase-II trial. Bone Marrow Transplant 2014; 49: 410–415.
Gratwohl A, Schmid O, Baldomero H, Horisberger B, Urbano-Ispizua A. . Haematopoietic stem cell transplantation (HSCT) in Europe 2002. Changes in indication and impact of team density. A report of the EBMT activity survey. Bone Marrow Transplant 2004; 34: 855–875.
Passweg JR, Baldomero H, Peters C, Gaspar HB, Cesaro S, Dreger P et al. Hematopoietic SCT in Europe: data and trends in 2012 with special consideration of pediatric transplantation. Bone Marrow Transplant 2014; 49: 744–750.
Michallet M, Tanguy ML, Socie G, Thiebaut A, Belhabri A, Milpied N et al. Second allogeneic haematopoietic stem cell transplantation in relapsed acute and chronic leukaemias for patients who underwent a first allogeneic bone marrow transplantation: a survey of the Societe Francaise de Greffe de moelle (SFGM). Br. J. Haematol. 2000; 108: 400–407.
Eapen M, Giralt SA, Horowitz MM, Klein JP, Wagner JE, Zhang MJ et al. Second transplant for acute and chronic leukemia relapsing after first HLA-identical sibling transplant. Bone Marrow Transplant 2004; 34: 721–727.
Christopeit M, Kuss O, Finke J, Bacher U, Beelen D, Bornhäuser M et al. Second allograft for hematological relapse of acute leukemia after first allogeneic SCT from related and unrelated donors – the role of donor change. J Clin Oncol 2013; 31: 3259–3271.
Christopoulos P, Schmoor C, Waterhouse M, Marks R, Wasch R, Bertz H et al. Reduced-intensity conditioning with fludarabine and thiotepa for second allogeneic transplantation of relapsed patients with AML. Bone Marrow Transplant 2013; 48: 901–907.
Vrhovac R, Labopin M, Ciceri F, Finke J, Holler E, Tischer J et al. Second RIC allogeneic transplants as a rescue strategy for acute leukemia patients who relapse after an initial RIC allogeneic transplantation: analysis of risk factors and treatment outcomes. Bone Marrow Transplant 2014; 49 (Suppl. 1): S194–S195.
Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V et al. Defining the intensity of conditioning regimens: working definitions. Biol. Blood Marrow Transplant 2009; 15: 1628–1633.
Wudhikarn K, Brunstein CG, Bachanova V, Burns LJ, Cao Q, Weisdorf DJ. . Relapse of Lymphoma after Allogeneic Hematopoietic Cell Transplantation: Management Strategies and Outcome. Biol. Blood Marrow Transplant 2011; 17: 1497–1504.
Ram R, Gooley TA, Maloney DG, Press OW, Pagel JM, Petersdorf SH et al. Histology and time to progression predict survival for lymphoma recurring after reduced-intensity conditioning and allogeneic hematopoietic cell transplantation. Biol. Blood Marrow Transplant 2011; 17: 1537–1545.
Shaw BE, Mufti GJ, Mackinnon S, Cavenagh JD, Pearce RM, Towlson KE et al. Outcome of second allogeneic transplants using reduced-intensity conditioning following relapse of haematological malignancy after an initial allogeneic transplant. Bone Marrow Transplant 2008; 42: 783–789.
Sureda A, Robinson S, Canals C, Carella AM, Boogaerts MA, Caballero D et al. Reduced-intensity conditioning compared with conventional allogeneic stem-cell transplantation in relapsed or refractory Hodgkin's lymphoma: an analysis from the lymphoma Working Party of the European Group for Blood and Marrow Transplantation. J Clin Oncol. 2008; 26: 455–462.
Smith SM, Burns LJ, van BK, Lerademacher J, He W, Fenske TS et al. Hematopoietic cell transplantation for systemic mature t-cell non-hodgkin lymphoma. J Clin Oncol 2013; 31: 3100–3109.
Fenske TS, Zhang MJ, Carreras J, Ayala E, Burns LJ, Cashen A et al. Autologous or reduced-intensity conditioning allogeneic hematopoietic cell transplantation for chemotherapy-sensitive mantle-cell lymphoma: analysis of transplantation timing and modality. J Clin Oncol 2013; 32: 273–281.
Dietrich S, Boumendil A, Finel H, Avivi I, Volin L, Cornelissen J et al. Outcome and prognostic factors in patients with mantle-cell lymphoma relapsing after autologous stem cell transplantation: A retrospective study of the European Group for Blood and Marrow Transplantation (EBMT). Ann Oncol 2014; 25: 1053–1058.
Avivi I, Canals C, Vernant JP, Wulf G, Nagler A, Hermine O et al. Matched unrelated donor allogeneic transplantation provides comparable long-term outcome to HLA-identical sibling transplantation in relapsed diffuse large B-cell lymphoma. Bone Marrow Transplant 2014; 49: 671–678.
van Besien K, Carreras J, Bierman PJ, Logan BR, Molina A, King R et al. Unrelated donor hematopoietic cell transplantation for non-hodgkin lymphoma: long-term outcomes. Biol. Blood Marrow Transplant. 2009; 15: 554–563.
Robinson SP, Canals C, Luang JJ, Tilly H, Crawley C, Cahn JY et al. The outcome of reduced intensity allogeneic stem cell transplantation and autologous stem cell transplantation when performed as a first transplant strategy in relapsed follicular lymphoma: an analysis from the Lymphoma Working Party of the EBMT. Bone Marrow Transplant 2013; 48: 1409–1414.
Le Gouill S, Milpied N, Buzyn A, De Latour RP, Vernant JP, Mohty M et al. Graft-versus-lymphoma effect for aggressive T-cell lymphomas in adults: a study by the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire. J Clin Oncol 2008; 26: 2264–2271.
Robinson SP, Boumendil A, Finel H, Montoto S, Dreger P. . Reduced intensity allogeneic stem cell transplantation for follicular lymphoma relapsing after an autologous transplantation. an analysis from the EBMT. Blood (ASH Annual Meeting Abstracts) 2013; 122: 420.
Kahl C, Storer BE, Sandmaier BM, Mielcarek M, Maris MB, Blume KG et al. Relapse risk in patients with malignant diseases given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning. Blood 2007; 110: 2744–2748.
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We thank all EBMT centers that participated in this study.
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Presented in part in abstract form at the 55th Annual Meeting of the American Society of Hematology, New Orleans, USA, 8 December, 2013; and at the 40th Annual Meeting of the European Society of Blood and Marrow Transplantation, Milan, Italy, 2 April, 2014.
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Horstmann, K., Boumendil, A., Finke, J. et al. Second allo-SCT in patients with lymphoma relapse after a first allogeneic transplantation. A retrospective study of the EBMT Lymphoma Working Party. Bone Marrow Transplant 50, 790–794 (2015). https://doi.org/10.1038/bmt.2015.12
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DOI: https://doi.org/10.1038/bmt.2015.12
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