Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab - PubMed (original) (raw)

Clinical Trial

. 2008 Jun 15;111(12):5530-6.

doi: 10.1182/blood-2008-01-136242. Epub 2008 Apr 14.

Peter McLaughlin, Rima M Saliba, Chitra Hosing, Martin Korbling, Ming S Lee, L Jeffrey Medeiros, Luis Fayad, Felipe Samaniego, Amin Alousi, Paolo Anderlini, Daniel Couriel, Marcos de Lima, Sergio Giralt, Sattva S Neelapu, Naoto T Ueno, Barry I Samuels, Fredrick Hagemeister, Larry W Kwak, Richard E Champlin

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Clinical Trial

Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab

Issa F Khouri et al. Blood. 2008.

Erratum in

Abstract

Nonmyeloablative stem cell transplantation in patients with follicular lymphoma has been designed to exploit the graft-versus-lymphoma immunity. The long-term effectiveness and toxicity of this strategy, however, is unknown. In this prospective study, we analyzed our 8-year experience. Patients received a conditioning regimen of fludarabine (30 mg/m(2) daily for 3 days), cyclophosphamide (750 mg/m(2) daily for 3 days), and rituximab (375 mg/m(2) for 1 day plus 1000 mg/m(2) for 3 days). They were then given an infusion of human leukocyte antigen-matched hematopoietic cells from related (n = 45) or unrelated donors (n = 2). Tacrolimus and methotrexate were used for graft-versus-host disease (GVHD) prophylaxis. Forty-seven patients were included. All patients experienced complete remission, with only 2 relapses. With a median follow-up time of 60 months (range, 19-94), the estimated survival and progression-free survival rates were 85% and 83%, respectively. All 18 patients who were tested and had evidence of JH/bcl-2 fusion transcripts in the bone marrow at study entry experienced continuous molecular remission. The incidence of grade 2-IV acute GVHD was 11%. Only 5 patients were still undergoing immunosuppressive therapy at the time of last follow-up. We believe that the described results are a step forward toward developing a curative strategy for recurrent follicular lymphoma.

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Figures

Figure 1

Figure 1

Peripheral blood CD19+ recovery after transplantation.

Figure 2

Figure 2

Proportion of patients with normal immunoglobulin (Ig) levels after transplantation.

Figure 3

Figure 3

OS (solid line) and PFS were 85% and 83%, respectively, with a median follow-up of 60 months (range, 19-94 months).

Figure 4

Figure 4

Incidence of severe acute GVHD after nonmyeloablative stem cell transplantation.

Figure 5

Figure 5

Incidence (—) and survival duration (----) of patients with chronic extensive and limited GVHD.

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References

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