4.2 Article

Similar and promising outcomes in lymphoma patients treated with myeloablative or nonmyeloablative conditioning and allogeneic hematopoietic cell transplantation

Journal

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 14, Issue 5, Pages 538-545

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2008.02.014

Keywords

lymphoma; allogeneic transplantation; nonmyeloablative

Funding

  1. NCI NIH HHS [L30 CA130661-01] Funding Source: Medline

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We compared the outcomes of 141 consecutive patients who received allogeneic transplantation with either myeloablative (MA) or nomnyeloablative/reduced intensity (NMA) conditioning for non-Hodgkin and Hodgkin lymphoma at the University of Minnesota. All patients were transplanted between 1997 and 2004. NMA transplant recipients were older and received umbilical cord blood grafts more frequently (MA: 6 [9%]; NMA: 33 [43%], P < .001). NMA patients had more advanced disease and 30 (39%) patients had undergone prior autologous transplantation. The 4-year overall survival (OS) (MA: 46% versus NMA: 49%; p = .34) and the 3-year progression-free survival (PFS) (MA: 44% versus NMA: 31%; P = 0.82) were similar after MA or NMA conditioning. However, MA conditioning resulted in significantly higher 1-year treatment-related mortality (TRM) (MA: 43% versus NMA: 17%; P < .01) but a lower risk of relapse at 3 years (MA: 11% versus NMA: 36%; P < .01). We conclude that similar transplant outcomes are achieved after allogeneic hemaropoietic stem cell transplantation using MA conditioning in younger patients and NMA conditioning in older patients or those with prior autologous transplantation not eligible for MA conditioning. Modifications to refine patient assignment to the preferred conditioning intensity and reduce relapse risks with NMA approaches are needed. (C) 2008 American Society for Blood and Marrow Transplantation.

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