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

Blood - Tập 111 Số 12 - Trang 5530-5536 - 2008
Issa F. Khouri1, Peter McLaughlin2, Rima M. Saliba1, Chitra Hosing1, Martin Körbling1, Ming S. Lee3, L. Jeffrey Medeiros3, Luis Fayad2, Felipe Samaniego2, Amin Alousi1, Paolo Anderlini1, Daniel R. Couriel1, Marcos de Lima1, Sergio Giralt1, Sattva S. Neelapu2, Naoto T. Ueno1, Barry I. Samuels4, Fredrick Hagemeister2, Larry W. Kwak2, Richard E. Champlin1
1Departments ofStem Cell Transplantation and Cellular Therapy,
2Lymphoma and Myeloma
3Hematopathology, and
4Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston

Tóm tắt

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/m2 daily for 3 days), cyclophosphamide (750 mg/m2 daily for 3 days), and rituximab (375 mg/m2 for 1 day plus 1000 mg/m2 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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Blood

Tập 111 Số 12

5530-5536

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