Reduced-intensity conditioning allogeneic stem cell transplant for relapsed or transformed aggressive B-cell non-Hodgkin lymphoma

Abstract

The role of reduced-intensity conditioning allogeneic stem cell transplant (RIC allo-SCT) in aggressive B-cell non-Hodgkin lymphoma (NHL) remains a matter of debate. This single-center analysis aimed to assess the potential benefit of RIC allo-SCT in 19 consecutive patients with relapsed or transformed aggressive B-cell NHL. Aggressive transformation (primary or secondary) was documented for these patients by pathological examination. In this series, all patients but two (n = 17; 89.5%) could actually receive autologous stem cell transplant (auto-SCT) prior to RIC allo-SCT. At the time of allo-SCT, eight patients (42%) were in first complete remission (CR), six (31.5%) were beyond first CR, and five (26.5%) were in partial remission. With a median follow-up of 32 (range, 3–86) months, nine patients experienced grade 2–4 acute GVHD (47.5%) and 10 patients had extensive chronic GVHD (52.5%). Overall, the incidence of non-relapse mortality was 26% (95% CI, 8–44%). At last follow-up, 12 patients (63%) were in sustained CR. The Kaplan–Meier estimates of progression-free and overall survival rates were 68% and 68%, respectively, at 4 years. We conclude that RIC allo-SCT after auto-SCT is feasible and a potentially efficient therapy for relapsed or transformed aggressive B-cell NHL, warranting further prospective evaluation.

Keywords:

• RIC allo-SCT
• auto-SCT
• aggressive lymphomas

Acknowledgements

We would like to thank the nursing staff for providing excellent care for our patients.

Declaration of interest: We thank the ‘Région Pays de Loire,’ the ‘Association pour la Recherche sur le Cancer (ARC),’ the ‘Fondation de France,’ the ‘Fondation contre la Leucémie,’ the ‘Agence de Biomédecine,’ the ‘Association Cent pour Sang la Vie,’ and the ‘Association Laurette Fuguain’ for their generous and continuous support of our clinical and basic research work.