Allogeneic hematopoietic cell transplantation after failed autologous transplant for lymphoma using TLI and anti-thymocyte globulin conditioning

作者：Rezvani A R^*; Kanate A S; Efron B; Chhabra S; Kohrt H E; Shizuru J A; Laport G G; Miklos D B; Benjamin J E; Johnston L J; Arai S; Weng W K; Negrin R S; Strober S; Lowsky R

来源：Bone Marrow Transplantation, 2015, 50(10): 1286-1292.

DOI：10.1038/bmt.2015.149

We describe 47 patients with lymphoma and failed prior autologous hematopoietic cell transplantation (HCT) who received TLI-ATG (anti-thymocyte globulin) conditioning followed by allogeneic HCT. Thirty-two patients had non-Hodgkin lymphoma (NHL; diffuse large B-cell lymphoma (n = 19), T-cell NHL (n = 6), mantle cell lymphoma (n = 4) or other B-cell subtypes (n = 3)), and 15 had Hodgkin lymphoma. The median follow-up was 4.9 (range, 2.1-11.9) years. The cumulative incidence of grade II-IV acute GvHD at day + 100 was 12%, and the cumulative incidence of extensive chronic GvHD at 1 year was 36%. The 3-year cumulative incidences of overall survival (OS), PFS and non-relapse mortality (NRM) were 81%, 44% and 7%, respectively. Fifteen patients died (relapse, n = 10; NRM, n = 5). Among the 25 patients with relapse after allogeneic HCT, 11 (44%) achieved durable (41 year) CRs following donor lymphocyte infusion or chemoradiotherapy. The majority of surviving patients (75%; n = 24) were able to discontinue all immunosuppression. For patients with relapsed lymphoma after autologous HCT, allogeneic HCT using TLI-ATG conditioning is a well-tolerated, predominantly outpatient therapy with low NRM (7% at 3 years), a low incidence of GvHD, durable disease control and excellent OS (81% at 3 years).

• 出版日期2015-10