Reduced-intensity hematopoietic stem-cell transplantation for malignant lymphoma: A retrospective survey of 112 adult patients in Japan

E. Kusumi, M. Kami, Y. Kanda, N. Murashige, Y. Kishi, R. Suzuki, K. Takeuchi, T. E. Tanimoto, T. Mori, K. Muta, T. Tamaki, Y. Tanaka, H. Ogawa, T. Yamane, S. Taniguchi, Y. Takaue

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Abstract

We conducted a nation-wide survey of 112 adult Japanese patients who underwent reduced-intensity stem cell transplantation (RIST) from 1999 to 2002. Underlying diseases included indolent (n = 45), aggressive (n = 58) and highly aggressive lymphomas (n = 9). Median age of the patients was 49 years. A total of 40 patients (36%) had relapsed diseases after autologous stem cell transplantation and 36 patients (32%) had received radiotherapy. RIST regimens were fludarabine-based (n = 95), low-dose total body irradiation-based (n = 6) and others (n = 11). Cumulative incidences of grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD were, respectively, 49 and 59%. Cumulative incidences of progression and progression-free mortality were 18 and 25%, respectively. With a median follow-up of 23.9 months, 3-year overall survival rates were 59%. A multivariate analysis identified three significant factors for progression, which are history of radiation (relative risk (RR) 3.45, confidential interval (CI) 1.12-10.0, P = 0.03), central nervous system involvement (RR 6.25, CI 2.08-20.0, P = 0.001) and development of GVHD (RR 0.28, CI 0.090-0.86, P = 0.026). RIST may have decreased the rate of transplant-related mortality, and GVHD may have induced a graft-versus-lymphoma effect. However, whether or not these potential benefits can be directly translated into improved patient survival should be evaluated in further studies.

Original languageEnglish
Pages (from-to)205-213
Number of pages9
JournalBone Marrow Transplantation
Volume36
Issue number3
DOIs
Publication statusPublished - 2005 Aug

Keywords

  • Aggressive lymphoma
  • Graft-versus-host disease
  • Graft-versus-lymphoma effect
  • Indolent lymphoma
  • Nonmyeloablative hematopoietic stem cell transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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  • Cite this

    Kusumi, E., Kami, M., Kanda, Y., Murashige, N., Kishi, Y., Suzuki, R., Takeuchi, K., Tanimoto, T. E., Mori, T., Muta, K., Tamaki, T., Tanaka, Y., Ogawa, H., Yamane, T., Taniguchi, S., & Takaue, Y. (2005). Reduced-intensity hematopoietic stem-cell transplantation for malignant lymphoma: A retrospective survey of 112 adult patients in Japan. Bone Marrow Transplantation, 36(3), 205-213. https://doi.org/10.1038/sj.bmt.1705027