Non-myeloablative allogeneic haematopoietic cell transplantation for relapsed diffuse large B-cell lymphoma: A multicentre experience

Andrew R. Rezvani, Lalitha Norasetthada, Ted Gooley, Mohamed Sorror, Michelle E. Bouvier, Firoozeh Sahebi, Edward Agura, Thomas Chauncey, Richard T. Maziarz, Michael Maris, Judith Shizuru, Benedetto Bruno, Christopher Bredeson, Thoralf Lange, Andrew M Yeager, Brenda M. Sandmaier, Rainer F. Storb, David G. Maloney

Research output: Contribution to journalArticle

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Abstract

Patients with relapsed diffuse large B-cell lymphoma (DLBCL) who have failed or are ineligible for autologous haematopoietic cell transplantation (HCT) have a poor prognosis. We examined the outcomes of non-myeloablative allogeneic HCT in this setting. Thirty-one patients with DLBCL and one patient with Burkitt lymphoma received allogeneic HCT following 2 Gy total body irradiation with or without fludarabine. Median age was 52 years. Twenty-four patients (75%) had undergone prior autologous HCT. Disease status at HCT was complete response (14/32, 44%), partial response (9/32, 28%), or refractory (9/32, 28%). Cumulative incidences of acute graft-versus-host disease (GVHD) grades II-IV, grades III-IV, and chronic GVHD were 53%, 19%, and 47% respectively. With a median follow-up of 45 months, 3-year estimated overall (OS) and progression-free survival (PFS) was 45% and 35% respectively. Three-year cumulative incidences of relapse and non-relapse mortality were 41% and 25% respectively. In multivariate models, chemosensitive disease and receipt of ≥4 lines of treatment before HCT were associated with better OS. Patients with chemosensitive disease had 3-year OS and PFS of 56% and 43% respectively. Non-myeloablative allogeneic HCT can produce long-term disease-free survival in patients with chemosensitive relapsed DLBCL who have failed or are ineligible for autologous HCT.

Original languageEnglish (US)
Pages (from-to)395-403
Number of pages9
JournalBritish Journal of Haematology
Volume143
Issue number3
DOIs
StatePublished - Nov 2008

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Lymphoma, Large B-Cell, Diffuse
Cell Transplantation
Disease-Free Survival
Graft vs Host Disease
Burkitt Lymphoma
Whole-Body Irradiation
Incidence
Recurrence
Mortality

Keywords

  • Aggressive non-Hodgkin lymphoma
  • Graft-versus-tumour effect
  • Haematopoietic cell transplantation
  • Immunotherapy
  • Reduced-intensity conditioning

ASJC Scopus subject areas

  • Hematology

Cite this

Non-myeloablative allogeneic haematopoietic cell transplantation for relapsed diffuse large B-cell lymphoma : A multicentre experience. / Rezvani, Andrew R.; Norasetthada, Lalitha; Gooley, Ted; Sorror, Mohamed; Bouvier, Michelle E.; Sahebi, Firoozeh; Agura, Edward; Chauncey, Thomas; Maziarz, Richard T.; Maris, Michael; Shizuru, Judith; Bruno, Benedetto; Bredeson, Christopher; Lange, Thoralf; Yeager, Andrew M; Sandmaier, Brenda M.; Storb, Rainer F.; Maloney, David G.

In: British Journal of Haematology, Vol. 143, No. 3, 11.2008, p. 395-403.

Research output: Contribution to journalArticle

Rezvani, AR, Norasetthada, L, Gooley, T, Sorror, M, Bouvier, ME, Sahebi, F, Agura, E, Chauncey, T, Maziarz, RT, Maris, M, Shizuru, J, Bruno, B, Bredeson, C, Lange, T, Yeager, AM, Sandmaier, BM, Storb, RF & Maloney, DG 2008, 'Non-myeloablative allogeneic haematopoietic cell transplantation for relapsed diffuse large B-cell lymphoma: A multicentre experience', British Journal of Haematology, vol. 143, no. 3, pp. 395-403. https://doi.org/10.1111/j.1365-2141.2008.07365.x
Rezvani, Andrew R. ; Norasetthada, Lalitha ; Gooley, Ted ; Sorror, Mohamed ; Bouvier, Michelle E. ; Sahebi, Firoozeh ; Agura, Edward ; Chauncey, Thomas ; Maziarz, Richard T. ; Maris, Michael ; Shizuru, Judith ; Bruno, Benedetto ; Bredeson, Christopher ; Lange, Thoralf ; Yeager, Andrew M ; Sandmaier, Brenda M. ; Storb, Rainer F. ; Maloney, David G. / Non-myeloablative allogeneic haematopoietic cell transplantation for relapsed diffuse large B-cell lymphoma : A multicentre experience. In: British Journal of Haematology. 2008 ; Vol. 143, No. 3. pp. 395-403.
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abstract = "Patients with relapsed diffuse large B-cell lymphoma (DLBCL) who have failed or are ineligible for autologous haematopoietic cell transplantation (HCT) have a poor prognosis. We examined the outcomes of non-myeloablative allogeneic HCT in this setting. Thirty-one patients with DLBCL and one patient with Burkitt lymphoma received allogeneic HCT following 2 Gy total body irradiation with or without fludarabine. Median age was 52 years. Twenty-four patients (75{\%}) had undergone prior autologous HCT. Disease status at HCT was complete response (14/32, 44{\%}), partial response (9/32, 28{\%}), or refractory (9/32, 28{\%}). Cumulative incidences of acute graft-versus-host disease (GVHD) grades II-IV, grades III-IV, and chronic GVHD were 53{\%}, 19{\%}, and 47{\%} respectively. With a median follow-up of 45 months, 3-year estimated overall (OS) and progression-free survival (PFS) was 45{\%} and 35{\%} respectively. Three-year cumulative incidences of relapse and non-relapse mortality were 41{\%} and 25{\%} respectively. In multivariate models, chemosensitive disease and receipt of ≥4 lines of treatment before HCT were associated with better OS. Patients with chemosensitive disease had 3-year OS and PFS of 56{\%} and 43{\%} respectively. Non-myeloablative allogeneic HCT can produce long-term disease-free survival in patients with chemosensitive relapsed DLBCL who have failed or are ineligible for autologous HCT.",
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AU - Sorror, Mohamed

AU - Bouvier, Michelle E.

AU - Sahebi, Firoozeh

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AU - Chauncey, Thomas

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N2 - Patients with relapsed diffuse large B-cell lymphoma (DLBCL) who have failed or are ineligible for autologous haematopoietic cell transplantation (HCT) have a poor prognosis. We examined the outcomes of non-myeloablative allogeneic HCT in this setting. Thirty-one patients with DLBCL and one patient with Burkitt lymphoma received allogeneic HCT following 2 Gy total body irradiation with or without fludarabine. Median age was 52 years. Twenty-four patients (75%) had undergone prior autologous HCT. Disease status at HCT was complete response (14/32, 44%), partial response (9/32, 28%), or refractory (9/32, 28%). Cumulative incidences of acute graft-versus-host disease (GVHD) grades II-IV, grades III-IV, and chronic GVHD were 53%, 19%, and 47% respectively. With a median follow-up of 45 months, 3-year estimated overall (OS) and progression-free survival (PFS) was 45% and 35% respectively. Three-year cumulative incidences of relapse and non-relapse mortality were 41% and 25% respectively. In multivariate models, chemosensitive disease and receipt of ≥4 lines of treatment before HCT were associated with better OS. Patients with chemosensitive disease had 3-year OS and PFS of 56% and 43% respectively. Non-myeloablative allogeneic HCT can produce long-term disease-free survival in patients with chemosensitive relapsed DLBCL who have failed or are ineligible for autologous HCT.

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