Outcomes of allogeneic hematopoietic stem cell transplantation for lymphomas: a single-institution experience

Abstract

Introduction: Allogeneic hematopoietic stem cell transplantation offers the opportunity for extended survival in patients with Hodgkin's and non-Hodgkin lymphomas who relapsed after, or were deemed ineligible for, autologous transplantation. This study reports the cumulative experience of a single center over the past 14 years aiming to define the impact of patient, disease, and transplant-related characteristics on outcomes.

Methods: All patients with histologically confirmed diagnosis of Hodgkin's or non-Hodgkin lymphomas who received allogeneic transplantation from 2000 to 2014 were retrospectively studied.

Results: Forty-one patients were reviewed: 10 (24%) had Hodgkin's and 31 (76%) had non-Hodgkin lymphomas. The median age was 50 years and 23 (56%) were male. The majority of patients (68%) had had a prior autologous transplantation. At the time of allogeneic transplantation, 18 (43%) patients were in complete and seven (17%) were in partial remission. Most (95%) patients received reduced-intensity conditioning, 49% received matched sibling donor grafts, 24% matched-unrelated donor grafts, and 27% received double umbilical cord blood grafts. The 100-day treatment-related mortality rate was 12%. After a median duration of follow up of 17.1 months, the median progression-free and overall survival was 40.5 and 95.8 months, respectively. On multivariate analysis, patients who had active disease at the time of transplant had inferior survival.

Conclusions: Allogeneic transplantation results extend survival in selected patients with relapsed/refractory Hodgkin's and non-Hodgkin lymphomas with low treatment-related mortality. Patients who have active disease at the time of allogeneic transplantation have poor outcomes.

Keywords: Lymphoma, Hodgkin's; Lymphoma, non-Hodgkin; Transplantation, hematopoietic, allogeneic.

Figure 1

Progression-free (A) and overall survival (OS) after allogeneic transplantation (with 95% confidence intervals).

Figure 2

Impact of disease and transplant-related factors on progression-free (PFS) and overall survival (OS) after allogeneic transplant; remission status prior to transplant (A, B), lymphoma subtype; Hodgkin's vs. non-Hodgkin lymphoma (C, D), graft source; matched-related donor (MRD) vs. matched-unrelated donor (MUD) vs. umbilical cord blood (UCB) grafts (E and F).