Allogeneic Stem Cell Transplantation for Relapsed/Refractory B Cell Lymphomas: Results of a Multicenter Phase II Prospective Trial including Rituximab in the Reduced-Intensity Conditioning Regimen

作者：Dodero Anna; Patriarca Francesca; Milone Giuseppe; Sarina Barbara; Miceli Rosalba; Iori Anna; Barretta Francesco; Terruzzi Elisabetta; Mussetti Alberto; Pini Massimo; Bosi Alberto; Dominietto Alida; Cascavilla Nicola; Onida Francesco; Narni Franco; Farina Lucia; Rambaldi Alessandro; Corradini Paolo

来源：Biology of Blood and Marrow Transplantation, 2017, 23(7): 1102-1109.

DOI：10.1016/j.bbmt.2017.03.031

• Rituximab
• Lymphoma
• Graft-versus-host disease-free/relapse-free survival

The treatment of patients with refractory/relapsed B cell non-Hodgkin lymphoma (NHL) is evolving because of the availability of novel drugs. Allogeneic stem cell transplantation (alloSCT) can be curative, but its morbidity and mortality remain a matter of concern. We conducted a multicenter prospective phase II trial to evaluate the benefit of including only 1 dose of rituximab in the conditioning regimen before alloSCT. The primary endpoint was progression-free survival. The study enrolled 121 patients with relapsed/refractory B cell lymphomas. The conditioning regimen consisted of thiotepa, cyclophosphamide, fludarabine, and rituximab (500 mg/m(2)). Rabbit antithymocyte globulin was administered only in case of unrelated donors. Sixty-seven '05%) and 54 (45%) patients received grafts from related and unrelated donors, respectively. The crude cumulative incidence (CCI) of nonrelapse mortality (NRM) was 21% at 3 years. The CCIs of chronic graft-verus'host disease (GVHD) at 3 years were 54% and 31% in recipients of matched sibling and unrelated grafts, respectively. At a median follow-up of 41 months, the estimated 3-year progression-free and overall survival were 50% and 61%, respectively. Long-term outcome was also evaluated with the composite endpoint of GVHDfree and relapse-free survival (GRFS). This is the first work evaluating the GRFS in a prospective trial of lymphoma patients: the 1-year and 3-year GRFS were 40% and 34%, respectively. AIIoSCT can cure a fraction of patients with rather low NRM and an encouraging PFS and GRFS.

• 出版日期2017-7