A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma

Abstract

plant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%, P ‫؍‬ .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%, P ‫؍‬ .05; and 34% versus 56%, P ‫؍‬ .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%, P ‫؍‬ .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%, P ‫؍‬ .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%, P ‫؍‬ .09; 44% versus 39%, P ‫؍‬ .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival

Stem cell transplantation for pediatric lymphoma: past, present and future

“…This compares with results reported by Levine et al 40 showing that pediatric patients with relapsed LL had a survival of 39% following highdose therapy and AutoSCT, whereas the French group reported only one of eight patients with LL who were treated with high-dose therapy and AutoSCT was a longterm survivor (Table 1). 29 These results are disappointing for children and adolescents with this histological subtype and clearly demonstrate that a new approach is needed for this high-risk group of patients.…”

“…Although there was a similar DFS between AlloSCT vs AutoSCT in patients with LL (36 vs 39%), there was a significantly decreased risk of relapse following AlloSCT ( Figure 5). 40 Most recently, the BFM group reported the results in 20 children with relapsed or progressive ALCL following total body irradiation, cyclophosphamide, VP-16 followed by AlloSCT, a DFS of 75% with a relapse rate of only 10% and transplant-related mortality of 15% (Figure 2). 37 These data strongly suggest that there is an allogeneic GvLy effect in both childhood and adolescent LL and ALCL.…”

“…Relapse occurred in only two patients and occurred early at 2 and 4 months post transplant. 36 Levine et al 40 reported the results from International Bone Marrow Transplant Registry in 204 patients with LL (median age of 13 years) following high-dose therapy AutoSCT (n ¼ 128) vs AlloSCT (n ¼ 76). Although there was a similar DFS between AlloSCT vs AutoSCT in patients with LL (36 vs 39%), there was a significantly decreased risk of relapse following AlloSCT ( Figure 5).…”

Results of a lymphoblastic leukemia-like chemotherapy program with risk-adapted mediastinal irradiation and stem cell transplantation for adult patients with lymphoblastic lymphoma

“…The protocol was designed such that patients who were found to be positive for MRD were switched from standard chemotherapy to allogeneic SCT (or alternatively to HD therapy with autologous stem cell support). Past studies have confirmed the therapeutic efficacy of SCT in adults with LL [19,29,30], with survival rates of 55-72%, which almost overlap with the best results obtained with chemotherapy. Although allogeneic SCT might no longer be a routine choice in the current era of improved chemotherapy results [3,8,9], it remains the most effective treatment modality for acute lymphoid malignancies beyond CR1 [31].…”

Autotransplant conditioning regimens for aggressive lymphoma: are we on the right road?

“…Bone marrow involvement and disease status beyond first remission, however, were associated with inferior outcomes. 43 T-cell NHL also has an inferior prognosis when compared to B-cell NHL after CHOP therapy. Blystad et al 44 reported the use of various high-dose chemotherapy regimens and ASCT for chemosensitive relapsed or primary refractory T-cell NHL.…”