Allogeneic hematopoietic stem cell transplantation in patients with diffuse large B cell lymphoma relapsed after autologous stem cell transplantation: A GITMO study

L. Rigacci, B. Puccini, A. Dodero, P. Iacopino, L. Castagna, S. Bramanti, F. Ciceri, R. Fanin, A. Rambaldi, M. Falda, G. Milone, S. Guidi, M. F. Martelli, P. Mazza, R. Oneto, A. Bosi, R. Foà, P. Leoni, V. Liso, P. PioltelliN. Cascavilla, R. Scimé, V. Rizzoli, A. Ballestrero, R. Raimondi, W. Arcese, M. Musso, F. Benedetti, A. Guerrasio, I. Majolino, D. G. Lambertenghi, M. Baccarani, A. Bacigalupo, M. Petrini, A. M. Carella, A. Levis, G. La Nasa, F. Merli, F. Narni, F. Lauria, S. Cortelazzo, M. Longinotti, A. Olivieri, C. Favre, N. Cantore, G. A. Da Prada, C. Selleri, B. Bruno, M. Giovanni, G. Leone, P. Di Bartolomeo, S. Morandi, D. Vallisa

Research output: Contribution to journalArticle

Abstract

Patients who relapse after an autologous hematopoietic stem cell transplantation (SCT) have a very poor prognosis. We have retrospectively analyzed diffuse large B cell lymphoma patients who underwent an allo-SCT after an auto-SCT relapse reported in the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) database. From 1995 to 2008, 3449 autologous transplants were reported in the GITMO database. Eight hundred eighty-four patients relapsed or progressed after transplant; 165 patients, 19% of the relapsed patients, were treated with allo-transplant. The stem cell donor was related to the patient in 108 cases. A reduced intensity conditioning regimen was used in 116. After allo-SCT, 72 patients (43%) obtained a complete response and 9 obtained a partial response with an overall response rate of 49%; 84 patients (51%) experienced rapid progression of disease. Ninety-one patients died, 45 due to disease and 46 due to treatment-related mortality. Acute graft-versus-host disease was recorded in 57 patients and a chronic GvHD in 38 patients. With a median follow-up of 24 months (2-144) after allo, overall survival (OS) was 39%, and after a median of 21 months (2-138) after allo, progression-free survival (PFS) was 32%. Multivariate analysis indicated that the only factors affecting OS were status at allo-SCT, and those affecting PFS were status at allo-SCT and stem cell donor. This retrospective analysis shows that about onefifth of patients with diffuse large B cell lymphoma who experience relapse after autologous transplantation may be treated with allogeneic transplantation. Moreover, the only parameter affecting either OS or PFS was the response status at the time of allo-SCT.

Original languageEnglish
Pages (from-to)931-939
Number of pages9
JournalAnnals of Hematology
Volume91
Issue number6
DOIs
Publication statusPublished - Jun 2012

Keywords

  • Allogeneic stem cell transplantation
  • Autologous stem cell transplantation
  • Diffuse largeBcelllymphoma
  • Graft versus lymphoma
  • Reduced intensity conditioning regimen
  • Salvage therapy

ASJC Scopus subject areas

  • Hematology

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    Rigacci, L., Puccini, B., Dodero, A., Iacopino, P., Castagna, L., Bramanti, S., Ciceri, F., Fanin, R., Rambaldi, A., Falda, M., Milone, G., Guidi, S., Martelli, M. F., Mazza, P., Oneto, R., Bosi, A., Foà, R., Leoni, P., Liso, V., ... Vallisa, D. (2012). Allogeneic hematopoietic stem cell transplantation in patients with diffuse large B cell lymphoma relapsed after autologous stem cell transplantation: A GITMO study. Annals of Hematology, 91(6), 931-939. https://doi.org/10.1007/s00277-011-1395-9