TY - JOUR
T1 - Reduced-intensity hematopoietic stem-cell transplantation for malignant lymphoma
T2 - A retrospective survey of 112 adult patients in Japan
AU - Kusumi, E.
AU - Kami, M.
AU - Kanda, Y.
AU - Murashige, N.
AU - Kishi, Y.
AU - Suzuki, R.
AU - Takeuchi, K.
AU - Tanimoto, T. E.
AU - Mori, T.
AU - Muta, K.
AU - Tamaki, T.
AU - Tanaka, Y.
AU - Ogawa, H.
AU - Yamane, T.
AU - Taniguchi, S.
AU - Takaue, Y.
PY - 2005/8
Y1 - 2005/8
N2 - We conducted a nation-wide survey of 112 adult Japanese patients who underwent reduced-intensity stem cell transplantation (RIST) from 1999 to 2002. Underlying diseases included indolent (n = 45), aggressive (n = 58) and highly aggressive lymphomas (n = 9). Median age of the patients was 49 years. A total of 40 patients (36%) had relapsed diseases after autologous stem cell transplantation and 36 patients (32%) had received radiotherapy. RIST regimens were fludarabine-based (n = 95), low-dose total body irradiation-based (n = 6) and others (n = 11). Cumulative incidences of grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD were, respectively, 49 and 59%. Cumulative incidences of progression and progression-free mortality were 18 and 25%, respectively. With a median follow-up of 23.9 months, 3-year overall survival rates were 59%. A multivariate analysis identified three significant factors for progression, which are history of radiation (relative risk (RR) 3.45, confidential interval (CI) 1.12-10.0, P = 0.03), central nervous system involvement (RR 6.25, CI 2.08-20.0, P = 0.001) and development of GVHD (RR 0.28, CI 0.090-0.86, P = 0.026). RIST may have decreased the rate of transplant-related mortality, and GVHD may have induced a graft-versus-lymphoma effect. However, whether or not these potential benefits can be directly translated into improved patient survival should be evaluated in further studies.
AB - We conducted a nation-wide survey of 112 adult Japanese patients who underwent reduced-intensity stem cell transplantation (RIST) from 1999 to 2002. Underlying diseases included indolent (n = 45), aggressive (n = 58) and highly aggressive lymphomas (n = 9). Median age of the patients was 49 years. A total of 40 patients (36%) had relapsed diseases after autologous stem cell transplantation and 36 patients (32%) had received radiotherapy. RIST regimens were fludarabine-based (n = 95), low-dose total body irradiation-based (n = 6) and others (n = 11). Cumulative incidences of grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD were, respectively, 49 and 59%. Cumulative incidences of progression and progression-free mortality were 18 and 25%, respectively. With a median follow-up of 23.9 months, 3-year overall survival rates were 59%. A multivariate analysis identified three significant factors for progression, which are history of radiation (relative risk (RR) 3.45, confidential interval (CI) 1.12-10.0, P = 0.03), central nervous system involvement (RR 6.25, CI 2.08-20.0, P = 0.001) and development of GVHD (RR 0.28, CI 0.090-0.86, P = 0.026). RIST may have decreased the rate of transplant-related mortality, and GVHD may have induced a graft-versus-lymphoma effect. However, whether or not these potential benefits can be directly translated into improved patient survival should be evaluated in further studies.
KW - Aggressive lymphoma
KW - Graft-versus-host disease
KW - Graft-versus-lymphoma effect
KW - Indolent lymphoma
KW - Nonmyeloablative hematopoietic stem cell transplantation
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U2 - 10.1038/sj.bmt.1705027
DO - 10.1038/sj.bmt.1705027
M3 - Article
C2 - 15937505
AN - SCOPUS:23744478874
SN - 0268-3369
VL - 36
SP - 205
EP - 213
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 3
ER -