Second-line age-adjusted International Prognostic Index in patients with advanced non-Hodgkin lymphoma after T-cell depleted allogeneic hematopoietic SCT Journal Article


Authors: Perales, M. A.; Jenq, R.; Goldberg, J. D.; Wilton, A. S.; Lee, S. S. E.; Castro-Malaspina, H. R.; Hsu, K.; Papadopoulos, E. B.; van den Brink, M. R. M.; Boulad, F.; Kernan, N. A.; Small, T. N.; Wolden, S.; Collins, N. H.; Chiu, M.; Heller, G.; O'Reilly, R. J.; Kewalramani, T.; Young, J. W.; Jakubowski, A. A.
Article Title: Second-line age-adjusted International Prognostic Index in patients with advanced non-Hodgkin lymphoma after T-cell depleted allogeneic hematopoietic SCT
Abstract: T-cell depleted allogeneic hematopoietic SCT (TCD-HSCT) have shown durable disease-free survival with a low risk of GVHD in patients with AML. We investigated this approach in 61 patients with primary refractory or relapsed non-Hodgkin lymphoma (NHL), who underwent TCD-HSCT from January 1992 through September 2004. Patients received myeloablative cytoreduction consisting of hyperfractionated total body irradiation, followed by either thiotepa and cyclophosphamide (45 patients) or thiotepa and fludarabine (16 patients). We determined the second-line age-adjusted International Prognostic Index score (sAAIPI) before transplant transplant. Median follow-up of surviving patients is 6 years. The 10-year OS and EFS were 50% and 43%, respectively. The relapse rate at 10 years was 21% in patients with chemosensitive disease and 52% in those with resistant disease at time of HSCT. Nine of the 18 patients who relapsed entered a subsequent CR. OS (P=0.01) correlated with the sAAIPI. The incidence of grades II-IV acute GVHD was 18%. We conclude that allogeneic TCD-HSCT can induce high rates of OS and EFS in advanced NHL with a low incidence of GVHD. Furthermore, the sAAIPI can predict outcomes and may be used to select the most appropriate patients for this type of transplant. © 2010 Macmillan Publishers Limited All rights reserved.
Keywords: adolescent; adult; cancer survival; child; event free survival; human tissue; child, preschool; disease-free survival; middle aged; survival rate; transplantation, homologous; young adult; human cell; major clinical study; overall survival; fludarabine; advanced cancer; rituximab; drug megadose; recurrence risk; follow-up studies; antineoplastic agent; incidence; risk factors; cyclophosphamide; steroid; hematopoietic stem cell transplantation; chemosensitivity; thiotepa; survival time; acute graft versus host disease; chronic graft versus host disease; myeloablative conditioning; nonhodgkin lymphoma; whole body radiation; radiation dose fractionation; lymphoma, non-hodgkin; prognostic factors; predictive value of tests; allogeneic hematopoietic stem cell transplantation; cancer relapse; methylprednisolone; large cell lymphoma; t cell depletion; gvhd; graft vs host disease; granulocyte colony stimulating factor; follicular lymphoma; lymphocyte depletion; transplantation chimera; thymocyte antibody; non-hodgkin lymphoma; clinical assessment tool; allo-bmt; allogeneic t-cell depleted; second line age adjusted international prognostic index
Journal Title: Bone Marrow Transplantation
Volume: 45
Issue: 9
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2010-09-01
Start Page: 1408
End Page: 1416
Language: English
DOI: 10.1038/bmt.2009.371
PUBMED: 20062091
PROVIDER: scopus
PMCID: PMC3076892
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: BMTRE" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Andrew Wilton
    27 Wilton
  2. Nancy Kernan
    382 Kernan
  3. Trudy Small
    200 Small
  4. Farid Boulad
    255 Boulad
  5. Glenn Heller
    303 Heller
  6. Suzanne L Wolden
    424 Wolden
  7. Miguel-Angel Perales
    382 Perales
  8. Katharine C Hsu
    139 Hsu
  9. Robert R Jenq
    102 Jenq
  10. James W Young
    257 Young
  11. Richard O'Reilly
    487 O'Reilly
  12. Nancy Collins
    58 Collins
  13. Michelle Hae-Chung Chiu
    10 Chiu
  14. Sharon Sang Eun Lee
    2 Lee