Allogeneic haematopoietic cell transplantation after nonmyeloablative conditioning in patients with T-cell and natural killer-cell lymphomas.

Abstract

Patients with T-cell and natural killer-cell lymphomas have poor outcomes. This study examined the role of allogeneic haematopoietic cell transplantation (allo-HCT) after nonmyeloablative conditioning in this setting. Seventeen patients with T-cell lymphoma or NK-cell lymphoma, including three patients in first complete remission, received allo-HCT after 2 Gy total-body irradiation and fludarabine. The median age was 57 (range, 18-73) years. The median number of prior therapies was 3 (range, 1-7), six patients (35%) had failed prior autologous HCT, and five patients (29%) had refractory disease at the time of allograft. Postgrafting immunosuppression was provided with mycophenolate mofetil with ciclosporin or tacrolimus. After a median follow-up of 3.3 (range, 0.3-8.0) years among surviving patients, the estimated probabilities of 3-year overall and progression-free survival were 59% and 53%, respectively, while the estimated probabilities of non-relapse mortality and relapse at 3 years were 19% and 26%, respectively. Sixty-five percent of patients developed grades 2-4 acute graft-versus-host disease and 53% of patients developed chronic graft-versus-host disease. Allo-HCT after nonmyeloablative conditioning is a promising salvage option for selected patients with T-cell and NK-cell lymphomas. These results suggest that graft-versus-T-cell lymphoma activity is responsible for long-term disease control.

• Authors: Andrei R Shustov, Theodore A Gooley, Brenda M Sandmaier, Judith Shizuru, Mohamed L Sorror, Firoozeh Sahebi, Peter McSweeney, Dietger Niederwieser, Benedetto Bruno, Rainer Storb, David G Maloney
• Journal: British journal of haematology (Br J Haematol) Vol. 150 Issue 2 Pg. 170-8 (Jul 2010) ISSN: 1365-2141 [Electronic] England
• PMID: 20507311 (Publication Type: Evaluation Study, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Chronic Disease
• Disease Progression
• Female
• Graft Survival
• Graft vs Host Disease (etiology)
• Graft vs Tumor Effect
• Hematopoietic Stem Cell Transplantation (adverse effects, methods)
• Histocompatibility Testing
• Humans
• Immunosuppression Therapy (methods)
• Killer Cells, Natural (pathology)
• Lymphoma, T-Cell (immunology, therapy)
• Male
• Middle Aged
• Survival Analysis
• Transplantation Conditioning (adverse effects, methods)
• Treatment Outcome
• Young Adult