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Lymphoma

Allogeneic stem cell transplantation following reduced-intensity conditioning can induce durable clinical and molecular remissions in relapsed lymphomas: pre-transplant disease status and histotype heavily influence outcome

Leukemia volume 21, pages 2316–2323 (2007)Cite this article

Abstract

The safety and efficacy of reduced-intensity conditioning (RIC) followed by allogeneic stem cell transplantation (SCT) for relapsed lymphomas remains unresolved. We conducted a prospective, multicentered, phase II trial. A total of 170 relapsed/refractory lymphomas received a RIC regimen followed by SCT from sibling donors. The primary study end point was non-relapse mortality (NRM). Histologies were non-Hodgkin's lymphomas (NHL) (indolent (LG-NHL), n=63; aggressive (HG-NHL), n=61; mantle cell lymphoma (MCL), n=14) and Hodgkin's disease (HD, n=32). Median follow-up was 33 months (range, 12–82). The results show that frequencies were as follows: cumulative NRM at 3 years, 14%; acute and chronic graft-versus-host disease (GVHD) 35 and 52%, respectively; 3-year overall survival (OS), 69% for LG-NHL, 69% for HG-NHL, 45% for MCL and 32% for HD (P=0.058); and 3-year relapse incidence, 29, 31, 35 and 81%, respectively (P<0.001). Relapse risk differed significantly at 3 years between follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL) (14 versus 46%, P=0.04). Molecular remission occurred in 94 and 40% (P=0.002) of patients with FL and CLL, respectively. On multivariate analysis, OS was influenced by chemorefractory disease (hazard ratio (HR)=3.6), diagnosis of HD (HR=3.5), and acute GVHD (HR=5.9). RIC allogeneic SCT is a feasible and effective salvage strategy in both indolent and aggressive NHL

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Acknowledgements

This work has been supported in part by grants from Associazione Italiana Ricerca sul Cancro (AIRC), FIRST University of Milano and Fondazione Michelangelo. The following centers and investigators contributed to the inclusion of patients in this study: Ciceri F, Department of Hematology, Ospedale San Raffaele, Milano; Benedetti F, Department of Hematology, University of Verona, Italy; Casini M, Department of Hematology, Ospedale San Maurizio, Bolzano, Italy; Levis A, Department of Hematology, Alessandria, Italy; Console G, Azienda Ospedaliera, Reggio Calabria, Italy; De Fabritis P, Department of Hematology, Ospedale S Eugenio, Roma, Italy; Brune M, University of Goeteborg, Sweden; Falda M, Department of Hematology , Ospedale San Giovanni Battista, Torino, Italy; Gallamini A, Department of Hematology, Azienda Ospedaliera Santa Croce, Cuneo, Italy; Di Bartolomeo P, Department of Hematology, Ospedale Civile, Pescara, Italy.

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Authors and Affiliations

  1. Division of Hematology and Bone Marrow Transplantation, Department of Hematology, Istituto Nazionale per lo Studio e la Cura dei Tumori, University of Milano, Milan, Italy

    P Corradini, A Dodero, L Farina, R Milani & C Carniti

  2. Department of Hematology, University of Udine, Udine, Italy

    R Fanin & F Patriarca

  3. Department of Medical Statistics, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy

    R Miceli

  4. Department of Medical Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori, University of Milano, Milan, Italy

    P Matteucci & A M Gianni

  5. Department of Hematology, Ospedale San Raffaele, Milan, Italy

    M Bregni

  6. Department of Bone Marrow Transplantation, Ospedale Cervello, Palermo, Italy

    R Scimè

  7. Department of Hematology,University of Modena, Modena, Italy

    F Narni

  8. Department of Hematology, University of Milano Bicocca, Milan, Italy

    E Pogliani

  9. Department of Hematology, Ospedale San Camillo-Forlanini, Roma, Italy

    A Locasciulli

  10. Department of Hematology, Ospedale San Martino, Genova, Italy

    A Bacigalupo

  11. Department of Hematology, Ospedale Riuniti, Bergamo, Italy

    A Rambaldi

  12. Department of Hematology–Oncology, University of Bologna, Bologna, Italy

    F Bonifazi

  13. Department of Hematology, University of Ancona, Ancona, Italy

    A Olivieri

  14. Department of Hematology, University of Torino, Turin, Italy

    C Tarella

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  1. P Corradini
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  12. A Locasciulli
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  14. C Carniti
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  18. A Olivieri
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  19. A M Gianni
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Correspondence to P Corradini.

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Corradini, P., Dodero, A., Farina, L. et al. Allogeneic stem cell transplantation following reduced-intensity conditioning can induce durable clinical and molecular remissions in relapsed lymphomas: pre-transplant disease status and histotype heavily influence outcome. Leukemia 21, 2316–2323 (2007). https://doi.org/10.1038/sj.leu.2404822

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