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. 2016 Apr-Jun;38(2):99-105.
doi: 10.1016/j.bjhh.2016.02.006. Epub 2016 Mar 19.

Allogeneic hematopoietic stem cell transplantation in patients with advanced indolent lymphoproliferative disorders

Ana Marcela Rojas Fonseca-Hial  1 , Katya Parisio  2 , Jose Salvador Rodrigues Oliveira  3
Affiliations

Allogeneic hematopoietic stem cell transplantation in patients with advanced indolent lymphoproliferative disorders

Ana Marcela Rojas Fonseca-Hial et al. Rev Bras Hematol Hemoter. 2016 Apr-Jun.

Abstract

Background: The role of allogeneic hematopoietic stem cell transplantation for advanced indolent lymphoproliferative disorders remains to be established.

Objective: This paper aims to describe the results of allogeneic hematopoietic stem cell transplantation in patients with advanced indolent lymphoproliferative disorders.

Methods: This article reports on 29 adult patients submitted to allogeneic transplantations from 1997 to 2010.

Results: Most had follicular non-Hodgkin lymphoma (n=14) or chronic lymphocytic leukemia (n=12). The median age was 44 years (range: 24-53 years) and 65% of patients were male. Only 21% had had access to rituximab and 45% to fludarabine. All had advanced disease (stage IV) with partial response or stable disease. Most underwent myeloablative conditioning n=17-59%). In this scenario, refractory disease was observed in seven (24%) patients, the 100-day mortality rate was 17% (n=5) and relapse occurred in four patients (18%). The main cause of death throughout the follow up was refractory disease in six of the 12 patients who died. Moderate and severe chronic graft-versus-host disease was frequent; about 41% of 24 patients analyzed. The overall survival rates and disease free survival at 42 months were 56.7% and 45.4%, respectively. According to Kaplan-Meyer analysis, the median time from diagnosis to transplant predicted the overall survival; however age, gender and conditioning regimen did not predict the prognosis. It was impossible to reach other conclusions because of the small sample size in this study.

Conclusions: The role of allogeneic transplantations should be re-evaluated in the era of targeted therapy.

Keywords: Allogeneic; Graft-versus-lymphoma; Hematopoietic stem cell transplant; Indolent lymphoproliferative disorder; Reduced intensity conditioning.

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Figures

Figure 1
Figure 1
Overall and disease free survival in advanced lymphoproliferative disorders and non-Hodgkin lymphoma after allogeneic hematopoietic stem cell transplantation.
Figure 2
Figure 2
Impact of age, gender, time of disease and conditioning on the overall survival.
See this image and copyright information in PMC

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