A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma

Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to auto...

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Veröffentlicht in:Blood 2003-04, Vol.101 (7), p.2476-2482
Hauptverfasser: Levine, John E., Harris, Richard E., Loberiza, Fausto R., Armitage, James O., Vose, Julie M., Van Besien, Koen, Lazarus, Hillard M., Horowitz, Mary M.
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container_end_page 2482
container_issue 7
container_start_page 2476
container_title Blood
container_volume 101
creator Levine, John E.
Harris, Richard E.
Loberiza, Fausto R.
Armitage, James O.
Vose, Julie M.
Van Besien, Koen
Lazarus, Hillard M.
Horowitz, Mary M.
description Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%,P= .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%,P= .05; and 34% versus 56%,P= .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%,P= .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%,P= .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%,P= .09; 44% versus 39%,P= .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.
doi_str_mv 10.1182/blood-2002-05-1483
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Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%,P= .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%,P= .05; and 34% versus 56%,P= .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%,P= .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%,P= .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%,P= .09; 44% versus 39%,P= .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. 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Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%,P= .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%,P= .05; and 34% versus 56%,P= .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%,P= .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%,P= .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%,P= .09; 44% versus 39%,P= .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Bone Marrow Transplantation - methods</subject><subject>Bone Marrow Transplantation - mortality</subject><subject>Bone Marrow Transplantation - statistics &amp; numerical data</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Data Collection</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematopoietic Stem Cell Transplantation - methods</subject><subject>Hematopoietic Stem Cell Transplantation - mortality</subject><subject>Hematopoietic Stem Cell Transplantation - statistics &amp; numerical data</subject><subject>Humans</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>Transplantation, Autologous - mortality</subject><subject>Transplantation, Autologous - statistics &amp; numerical data</subject><subject>Transplantation, Homologous - mortality</subject><subject>Transplantation, Homologous - statistics &amp; numerical data</subject><subject>Transplantation, Isogeneic</subject><subject>Treatment Outcome</subject><issn>0006-4971</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1L7TAQhoMoevz4Ay4kG91VkzRpWnAjcv0AwY2u4zSdaiRtatLjxX9vjueAO1dhXp53mDyEHHN2znktLlofQlcIxkTBVMFlXW6RBVeiLnLEtsmCMVYVstF8j-yn9M4Yl6VQu2SPC6kqxdSCvFxRG4YJokthpKGn4H14xRGdpTB2FJZzyEFYJtqGEekAMYb_dI4wpsnDOMPscrEPkfqvYXoLrYc05_J6GuCQ7PTgEx5t3gPyfPPv6fqueHi8vb--eiisbMRc8EoKhbphpcS27GvdMm67suEaJPZotS5BQi0ZaKh41ck2R1XdNGA7kefygJyt904xfCwxzWZwyaLPN2K-3uiSc60qmUGxBm0MKUXszRRd_taX4cysvJofr2bl1TBlVl5z6WSzfdkO2P1WNiIzcLoBIFnwffZjXfrlZFVLKZvMXa45zC4-HUaTrMPRYuci2tl0wf11xzczwpeR</recordid><startdate>20030401</startdate><enddate>20030401</enddate><creator>Levine, John E.</creator><creator>Harris, Richard E.</creator><creator>Loberiza, Fausto R.</creator><creator>Armitage, James O.</creator><creator>Vose, Julie M.</creator><creator>Van Besien, Koen</creator><creator>Lazarus, Hillard M.</creator><creator>Horowitz, Mary M.</creator><general>Elsevier Inc</general><general>The Americain Society of Hematology</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030401</creationdate><title>A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma</title><author>Levine, John E. ; Harris, Richard E. ; Loberiza, Fausto R. ; Armitage, James O. ; Vose, Julie M. ; Van Besien, Koen ; Lazarus, Hillard M. ; Horowitz, Mary M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c492t-16425e79034eb3f87b01cd3917a4efec773a4a840a7a616d4bc776899acd216d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anesthesia. 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Myelofibrosis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Transplantation, Autologous - mortality</topic><topic>Transplantation, Autologous - statistics &amp; numerical data</topic><topic>Transplantation, Homologous - mortality</topic><topic>Transplantation, Homologous - statistics &amp; numerical data</topic><topic>Transplantation, Isogeneic</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Levine, John E.</creatorcontrib><creatorcontrib>Harris, Richard E.</creatorcontrib><creatorcontrib>Loberiza, Fausto R.</creatorcontrib><creatorcontrib>Armitage, James O.</creatorcontrib><creatorcontrib>Vose, Julie M.</creatorcontrib><creatorcontrib>Van Besien, Koen</creatorcontrib><creatorcontrib>Lazarus, Hillard M.</creatorcontrib><creatorcontrib>Horowitz, Mary M.</creatorcontrib><creatorcontrib>on behalf of the Lymphoma Study Writing Committee of the International Bone Marrow Transplant Registry and Autologous Blood and Marrow Transplant Registry</creatorcontrib><creatorcontrib>Lymphoma Study Writing Committee, International Bone Marrow Transplant Registry and Autologous Blood and Marrow Transplant Registry</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Blood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Levine, John E.</au><au>Harris, Richard E.</au><au>Loberiza, Fausto R.</au><au>Armitage, James O.</au><au>Vose, Julie M.</au><au>Van Besien, Koen</au><au>Lazarus, Hillard M.</au><au>Horowitz, Mary M.</au><aucorp>on behalf of the Lymphoma Study Writing Committee of the International Bone Marrow Transplant Registry and Autologous Blood and Marrow Transplant Registry</aucorp><aucorp>Lymphoma Study Writing Committee, International Bone Marrow Transplant Registry and Autologous Blood and Marrow Transplant Registry</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma</atitle><jtitle>Blood</jtitle><addtitle>Blood</addtitle><date>2003-04-01</date><risdate>2003</risdate><volume>101</volume><issue>7</issue><spage>2476</spage><epage>2482</epage><pages>2476-2482</pages><issn>0006-4971</issn><eissn>1528-0020</eissn><abstract>Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%,P= .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%,P= .05; and 34% versus 56%,P= .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%,P= .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%,P= .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%,P= .09; 44% versus 39%,P= .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>12456505</pmid><doi>10.1182/blood-2002-05-1483</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Bone Marrow Transplantation - methods
Bone Marrow Transplantation - mortality
Bone Marrow Transplantation - statistics & numerical data
Bone marrow, stem cells transplantation. Graft versus host reaction
Child
Child, Preschool
Data Collection
Disease-Free Survival
Female
Hematologic and hematopoietic diseases
Hematopoietic Stem Cell Transplantation - methods
Hematopoietic Stem Cell Transplantation - mortality
Hematopoietic Stem Cell Transplantation - statistics & numerical data
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Male
Medical sciences
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Recurrence
Retrospective Studies
Survival Rate
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Transplantation, Autologous - mortality
Transplantation, Autologous - statistics & numerical data
Transplantation, Homologous - mortality
Transplantation, Homologous - statistics & numerical data
Transplantation, Isogeneic
Treatment Outcome
title A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma
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