Second allo-SCT in patients with lymphoma relapse after a first allogeneic transplantation. A retrospective study of the EBMT Lymphoma Working Party

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.

Post-transplantation Cyclophosphamide and Sirolimus after Haploidentical Hematopoietic Stem Cell Transplantation Using a Treosulfan-based Myeloablative Conditioning and Peripheral Blood Stem Cells

“…This has been particularly relevant with PTCy, given the significant rate of disease relapse observed. Although in our study overall efficacy is difficult to assess given the small [60][61][62][63] . Indeed, in our cohort 42% of patients receiving haploidentical HSCT2 for leukemia relapse after allogeneic transplantation could be rescued, with low rates of NRM.…”

Peripheral T-cell Lymphomas

“…reported that 17 patients with T-cell lymphoma underwent the second allo-HSCT and 5-year cumulative PFS after second allo-HSCT was 27%. [ 35 ] Chemosensitivity at the second allo-HSCT and interval between the two allo-HSCT (longer than 12 months or not) are significant risk factors for OS and PFS. This study provides first document for T-cell lymphoma that a second allo-HSCT can achieve long-term survival in a substantial fraction of patients with relapsed disease after first allo-HSCT.…”

Clinical Options in Relapsed or Refractory Hodgkin Lymphoma: An Updated Review

“…Recently, the LWP of the EBMT has reported [ 41 ] the results on the outcome of the second allo-SCT (allo-SCT-2) performed in one hundred and forty patients with lymphoma, of which 31% were affected by HL. Three-year PFS, OS, relapse incidence, and NRM were 19%, 29%, 58%, and 23%, respectively.…”