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Clinical Trial
. 2008 Aug;14(8):904-12.
doi: 10.1016/j.bbmt.2008.05.021.

Second autologous stem cell transplantation for relapsed lymphoma after a prior autologous transplant

Sonali M Smith  1 , Koen van Besien, Jeanette Carreras, Asad Bashey, Mitchell S Cairo, Cesar O Freytes, Robert Peter Gale, Gregory A Hale, Brandon Hayes-Lattin, Leona A Holmberg, Armand Keating, Richard T Maziarz, Philip L McCarthy, Willis H Navarro, Santiago Pavlovsky, Harry C Schouten, Matthew Seftel, Peter H Wiernik, Julie M Vose, Hillard M Lazarus, Parameswaran Hari
Affiliations
Clinical Trial

Second autologous stem cell transplantation for relapsed lymphoma after a prior autologous transplant

Sonali M Smith et al. Biol Blood Marrow Transplant. 2008 Aug.

Abstract

We determined treatment-related mortality, progression-free survival (PFS), and overall survival (OS) after a second autologous HCT (HCT2) for patients with lymphoma relapse after a prior HCT (HCT1). Outcomes for patients with either Hodgkin lymphoma (HL, n = 21) or non-Hodgkin lymphoma (NHL, n = 19) receiving HCT2 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) were analyzed. The median age at HCT2 was 38 years (range: 16-61) and 22 (58%) patients had a Karnofsky performance score <90. HCT2 was performed >1 year after HCT1 in 82%. The probability of treatment-related mortality at day 100 was 11% (95% confidence interval [CI], 3%-22%). The 1-, 3-, and 5-year probabilities of PFS were 50% (95% CI, 34%-66%), 36% (95% CI, 21%-52%), and 30% (95% CI, 16%-46%), respectively. Corresponding probabilities of survival were 65% (95% CI, 50%-79%), 36% (95% CI, 22%-52%), and 30% (95% CI, 17%-46%), respectively. At a median follow-up of 72 months (range: 12-124 months) after HCT2, 29 patients (73%) have died, 18 (62%) secondary to relapsed lymphoma. The outcomes of patients with HL and NHL were similar. In summary, this series represents the largest reported group of patients with relapsed lymphomas undergoing SCT2 following failed SCT1, and with long-term follow-up. Our series suggests that SCT2 is feasible in patients relapsing after prior HCT1, with a lower treatment-related mortality than that reported for allogeneic transplant in this setting. HCT2 should be considered for patients with relapsed HL or NHL after HCT1 without alternative allogeneic stem cell transplant options.

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Figures

Figure 1
Figure 1
Probability of PFS and OS for patients following HCT2.
Figure 2
Figure 2
Figure 2A. Probability of PFS by time to relapse from HCT1 Figure 2B. Probability of OS by time to relapse from HCT1
Figure 3
Figure 3
Figure 3A. Probability of PFS histology Figure 3B. Probability of OS histology
See this image and copyright information in PMC

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