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. 2010 Sep;45(9):1408-16.
doi: 10.1038/bmt.2009.371. Epub 2010 Jan 11.

Second-line age-adjusted International Prognostic Index in patients with advanced non-Hodgkin lymphoma after T-cell depleted allogeneic hematopoietic SCT

M-A Perales  1 , R Jenq, J D Goldberg, A S Wilton, S S E Lee, H R Castro-Malaspina, K Hsu, E B Papadopoulos, M R M van den Brink, F Boulad, N A Kernan, T N Small, S Wolden, N H Collins, M Chiu, G Heller, R J O'Reilly, T Kewalramani, J W Young, A A Jakubowski
Affiliations

Second-line age-adjusted International Prognostic Index in patients with advanced non-Hodgkin lymphoma after T-cell depleted allogeneic hematopoietic SCT

M-A Perales et al. Bone Marrow Transplant. 2010 Sep.

Abstract

T-cell depleted allogeneic hematopoietic SCT (TCD-HSCT) have shown durable disease-free survival with a low risk of GVHD in patients with AML. We investigated this approach in 61 patients with primary refractory or relapsed non-Hodgkin lymphoma (NHL), who underwent TCD-HSCT from January 1992 through September 2004. Patients received myeloablative cytoreduction consisting of hyperfractionated total body irradiation, followed by either thiotepa and cyclophosphamide (45 patients) or thiotepa and fludarabine (16 patients). We determined the second-line age-adjusted International Prognostic Index score (sAAIPI) before transplant transplant. Median follow-up of surviving patients is 6 years. The 10-year OS and EFS were 50% and 43%, respectively. The relapse rate at 10 years was 21% in patients with chemosensitive disease and 52% in those with resistant disease at time of HSCT. Nine of the 18 patients who relapsed entered a subsequent CR. OS (P=0.01) correlated with the sAAIPI. The incidence of grades II-IV acute GVHD was 18%. We conclude that allogeneic TCD-HSCT can induce high rates of OS and EFS in advanced NHL with a low incidence of GVHD. Furthermore, the sAAIPI can predict outcomes and may be used to select the most appropriate patients for this type of transplant.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier estimates of probability of OS (A) and EFS (B) for 61 patients transplanted with TCD grafts for advanced NHL.
Figure 2
Figure 2
OS (A) and EFS (B) for 61 patients transplanted with TCD grafts for advanced NHL stratified by NHL subtype. See Table 3 for details.
Figure 3
Figure 3
OS (A) and EFS (B) for patients, stratified by sAAIPI risk group: low-intermediate, intermediate, and high. Kaplan-Meier curves OS and (B) EFS in 61 transplanted patients, stratified by sAAIPI risk groups: low risk (0 factor), low-intermediate risk (1 factor), high-intermediate (2 factors), and high risk (3 factors). sAAIPI risk factors include KPS <80, LDH >normal, and stage III/IV. See Table 3 for details.
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