Alternate Donor Hematopoietic Cell Transplantation (HCT) in Non-Hodgkin Lymphoma Using Lower Intensity Conditioning: A Report from the CIBMTR

Gregory A. Hale, Smriti Shrestha, Jennifer Le-Rademacher, Linda J. Burns, John Gibson, David J. Inwards, Cesar O. Freytes, Brian J. Bolwell, Jack W. Hsu, Shimon Slavin, Luis Isola, David A. Rizzieri, Robert Peter Gale, Ginna G. Laport, Silvia Montoto, Hillard M. Lazarus, Parameswaran N. Hari

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

We analyzed the outcomes of 248 (61% male) adult recipients of HLA-matched unrelated and HLA-mismatched related donor hematopoietic cell transplantation (HCT) for non-Hodgkin lymphoma (NHL) after reduced or lower intensity conditioning (RIC), reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 1997 to 2004. Median age was 52 (range: 18-72 years); 31% had a Karnofsky performance score <90. Follicular NHL (43%) was the major histology. Incidence of grades II-IV acute graft-versus-host disease (aGVHD) was 43% at 100 days; and chronic GVHD (cGVHD) was 44% at 3 years. Treatment-related mortality (TRM) at 100 days was 24%. Three-year overall survival (OS) and progression-free survival (PFS) were 41% and 32%, respectively. In multivariate analysis, use of antithymocyte globulin (ATG) and HLA mismatch were associated with increased TRM. High-grade histology, ATG use, and chemotherapy resistance were associated with lower PFS. Older age, shorter interval from diagnosis to HCT, non-total body irridiation (TBI) conditioning regimens, ex vivo T cell depletion, and HLA-mismatched unrelated donors were associated with mortality. GVHD did not influence relapse or PFS. Older age, aggressive histology, and chemotherapy resistance correlated with poorer survival. For selected patients with NHL, lack of an available sibling donor should not be a barrier to allogeneic HCT.

Original languageEnglish (US)
JournalBiology of Blood and Marrow Transplantation
Volume18
Issue number7
DOIs
StatePublished - Jul 1 2012
Externally publishedYes

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Cell Transplantation
Non-Hodgkin's Lymphoma
Disease-Free Survival
Histology
Antilymphocyte Serum
Bone Marrow
Tissue Donors
Transplants
Mortality
Research
Drug Therapy
Unrelated Donors
Follicular Lymphoma
Survival
Graft vs Host Disease
Siblings
Multivariate Analysis
T-Lymphocytes
Recurrence
Incidence

Keywords

  • HCT
  • Non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Alternate Donor Hematopoietic Cell Transplantation (HCT) in Non-Hodgkin Lymphoma Using Lower Intensity Conditioning : A Report from the CIBMTR. / Hale, Gregory A.; Shrestha, Smriti; Le-Rademacher, Jennifer; Burns, Linda J.; Gibson, John; Inwards, David J.; Freytes, Cesar O.; Bolwell, Brian J.; Hsu, Jack W.; Slavin, Shimon; Isola, Luis; Rizzieri, David A.; Gale, Robert Peter; Laport, Ginna G.; Montoto, Silvia; Lazarus, Hillard M.; Hari, Parameswaran N.

In: Biology of Blood and Marrow Transplantation, Vol. 18, No. 7, 01.07.2012.

Research output: Contribution to journalArticle

Hale, GA, Shrestha, S, Le-Rademacher, J, Burns, LJ, Gibson, J, Inwards, DJ, Freytes, CO, Bolwell, BJ, Hsu, JW, Slavin, S, Isola, L, Rizzieri, DA, Gale, RP, Laport, GG, Montoto, S, Lazarus, HM & Hari, PN 2012, 'Alternate Donor Hematopoietic Cell Transplantation (HCT) in Non-Hodgkin Lymphoma Using Lower Intensity Conditioning: A Report from the CIBMTR', Biology of Blood and Marrow Transplantation, vol. 18, no. 7. https://doi.org/10.1016/j.bbmt.2011.11.026
Hale, Gregory A. ; Shrestha, Smriti ; Le-Rademacher, Jennifer ; Burns, Linda J. ; Gibson, John ; Inwards, David J. ; Freytes, Cesar O. ; Bolwell, Brian J. ; Hsu, Jack W. ; Slavin, Shimon ; Isola, Luis ; Rizzieri, David A. ; Gale, Robert Peter ; Laport, Ginna G. ; Montoto, Silvia ; Lazarus, Hillard M. ; Hari, Parameswaran N. / Alternate Donor Hematopoietic Cell Transplantation (HCT) in Non-Hodgkin Lymphoma Using Lower Intensity Conditioning : A Report from the CIBMTR. In: Biology of Blood and Marrow Transplantation. 2012 ; Vol. 18, No. 7.
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AU - Gale, Robert Peter

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