TY - JOUR
T1 - Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab
AU - Khouri, Issa F.
AU - McLaughlin, Peter
AU - Saliba, Rima M.
AU - Hosing, Chitra
AU - Korbling, Martin
AU - Lee, Ming S.
AU - Medeiros, L. Jeffrey
AU - Fayad, Luis
AU - Samaniego, Felipe
AU - Alousi, Amin
AU - Anderlini, Paolo
AU - Couriel, Daniel
AU - De Lima, Marcos
AU - Giralt, Sergio
AU - Neelapu, Sattva S.
AU - Ueno, Naoto T.
AU - Samuels, Barry I.
AU - Hagemeister, Fredrick
AU - Kwak, Larry W.
AU - Champlin, Richard E.
PY - 2008/6/15
Y1 - 2008/6/15
N2 - Nonmyeloablative stem cell transplantation in patients with follicular lymphoma has been designed to exploit the graftversus-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-versushost disease (GVHD) prophylaxis. Fortyseven 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 tran scripts 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.
AB - Nonmyeloablative stem cell transplantation in patients with follicular lymphoma has been designed to exploit the graftversus-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-versushost disease (GVHD) prophylaxis. Fortyseven 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 tran scripts 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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U2 - 10.1182/blood-2008-01-136242
DO - 10.1182/blood-2008-01-136242
M3 - Article
C2 - 18411419
AN - SCOPUS:45149097052
SN - 0006-4971
VL - 111
SP - 5530
EP - 5536
JO - Blood
JF - Blood
IS - 12
ER -