Autologous versus allogeneic bone marrow transplantation for non-Hodgkin's lymphoma: a case-controlled analysis of the European Bone Marrow Transplant Group Registry data.

Chopra, Rajesh; Goldstone, Anthony H.; Pearce, Rachel; Philip, Thierry; Petersen, Finn; Appelbaum, F; Vol, Edward De; Ernst, Peter

doi:10.1200/jco.1992.10.11.1690

Cited by 175 publications

(93 citation statements)

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“…A case controlled analysis of allogeneic vs autologous transplantation in 101 patients using data from the EBMTR was conducted and revealed a somewhat lower risk of relapse after allogeneic transplantation compared to auto-BMT (23 vs 38%). 8 However, again, disease-free survival was similar (49 vs 46%) due to higher toxicity in the allo-transplant group. In this study, a correlation between the development of chronic GVHD and protection from relapse was identified, supporting the notion of a graft-versus-lymphoma effect.…”

Section: Discussionmentioning

confidence: 92%

“…Several studies in patients with NHL have reported lower relapse rates after allogeneic BMT than after autologous transplant. [5][6][7][8][9] Lastly, in recent years, the risk of long-term complications such as myelodysplasia and secondary leukemias following autologous BMT for lymphoma has been recognized with increasing frequency. 10,11 If the morbidity and mortality associated with allogeneic transplantation could be reduced, then it might prove a superior alternative to autologous transplant procedures in certain patients with recurrent lymphoma.…”

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confidence: 99%

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CD6+ T cell-depleted allogeneic bone marrow transplantation for non-Hodgkin’s lymphoma

Soiffer

Freedman

Neuberg

et al. 1998

Bone Marrow Transplant

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Summary:For patients with non-Hodgkin's lymphoma (NHL) undergoing blood or bone marrow transplantation (BMT), the use of autologous grafts has often been preferred to that of allogeneic stem cells because of a significantly lower incidence of non-relapse mortality. If complications associated with allo-BMT could be minimized without compromising efficacy, then it might become a preferred strategy for certain subsets of patients. In this report, we describe the toxicity and long-term efficacy of T cell-depleted allogeneic BMT using anti-CD6 monoclonal antibody and complement alone to reduce the risk of GVHD and its sequelae. Twenty-two patients, aged 18-60 years, with high (n = 10), intermediate (n = 9), or low (n = 3) grade NHL underwent HLA-identical allogeneic BMT from siblings. Patients had either relapsed after at least one remission or never achieved a full remission with chemotherapy. Twenty patients had a history of marrow involvement. Bone marrow was depleted of CD6 + T cells with T12 monoclonal antibody and complement as the sole form of GVHD prophylaxis. Stable hematopoietic engraftment occurred in all 22 patients. Four patients developed grade 2 and 1 patient grade 3 GVHD (23% grades 2-4 GVHD). Chronic GVHD has occurred in three patients. Treatment-related mortality was very low. Only one patient died while in remission. Thirteen patients are alive and free of disease with a median follow-up of 30 months. Estimated event-free and overall survivals are 54 and 59%, respectively. CD6 allogeneic marrow transplantation is associated with a low risk of transplant-related complications and may offer advantages for certain patients with recurrent NHL felt to be at high risk for relapse after autologous transplantation.

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Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

CD6+ T cell-depleted allogeneic bone marrow transplantation for non-Hodgkin’s lymphoma

Soiffer

Freedman

Neuberg

et al. 1998

Bone Marrow Transplant

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“…Most retrospective studies on this issue showed that patients treated with allogeneic SCT were usually affected by more advanced or refractory disease, thus suggesting the existence of immune-mediated anti-tumor activity. [6][7][8] The additional evidence of clinical and molecular responses after the withdrawal of immunosuppressive therapy or donor lymphocyte infusions further supported the idea of an underlying GVL effect. 9,10 However, the main obstacle to a wide application of myeloablative allogeneic SCT, as a salvage strategy, was the high incidence of transplantrelated mortality (TRM) that offset the benefit of the GVL effect in terms of overall survival.…”

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confidence: 99%

Current role of allogeneic stem cell transplantation in follicular lymphoma

Farina¹,

Corradini²

2007

Haematologica

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“…The median time to reach more than 0.5 × 10 9 /l ANC was 16 (range, [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] …”

Section: Engraftmentmentioning

confidence: 99%

“…Non-randomized studies demonstrated a reduction of relapse by approximately half compared to autologous transplantation, but this advantage was upset by the high treatment-related mortality. [12][13][14][15] Nevertheless, some patients with poor prognosis NHL attain long-term clinical remissions. [16][17][18][19][20] As other hematologic malignances NHLs are characterized by non-random genetic alterations.…”

Section: Introductionmentioning

confidence: 99%

True

2001

Leukemia

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From 1987 to 1999 35 patients with poor prognosis non-Hodgkin's lymphoma (NHL) underwent allogeneic stem cell transplantation (SCT) at the University Hospitals of Vienna and Graz. Initial biopsy specimens were reclassified according to the Revised European-American Classification of Lymphoid Neoplasms (REAL). All patients surviving 28 days engrafted. Twenty-eight of them (93%) attained clinical remission. At the last follow-up 14 patients were alive and disease-free at a median of 5.0 (range, 2.3-12.9) years after allogeneic SCT. The actuarial overall survival is 35%. Five patients relapsed 1.8 to 27.6 months after transplant, the probability of relapse is 23%. Of the 21 deaths following SCT, seven were due to relapse/refractory disease and 14 due to transplant-related causes. The probability of treatment-related mortality is 48%. After SCT, minimal residual disease (MRD) was monitored by polymerase chain reaction (PCR) in seven patients with a BCL-2/IgH translocation and in 13 with a clonal immunoglobulin heavy chain (IgH) rearrangement. All 20 patients attained clinical remission rapidly and converted to PCR negativity. In the follow-up nine of these patients are in long-term clinical and molecular remission, six PCR-negative patients died of transplant-related causes and five patients relapsed. In summary, allogeneic stem cell transplantation has a curative potential for patients with refractory and recurrent non-Hodgkin's lymphoma. In our series long-term disease-free survival was associated with molecular disease eradication after SCT. Treatmentrelated mortality rate was high, thus earlier referral of selected patients to allogeneic SCT should be considered. Leukemia (2001) 15, 635-641.

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Autologous versus allogeneic bone marrow transplantation for non-Hodgkin's lymphoma: a case-controlled analysis of the European Bone Marrow Transplant Group Registry data.

Abstract: This study suggests that ABMT and alloBMT for non-Hodgkin's lymphoma are comparable, with the exception of lymphoblastic lymphoma in which a graft-versus-lymphoma effect may account for the lower relapse rate for patients who underwent alloBMT.

Cited by 175 publications

References 10 publications

CD6+ T cell-depleted allogeneic bone marrow transplantation for non-Hodgkin’s lymphoma

CD6+ T cell-depleted allogeneic bone marrow transplantation for non-Hodgkin’s lymphoma

Current role of allogeneic stem cell transplantation in follicular lymphoma

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