Researchers from the UK have reported a 48% progression-free survival in patients with relapsed diffuse large B-cell lymphoma (DLBCL) following reduced-intensity allogeneic stem cell transplantation. The details of this Phase II study appeared in the January 20, 2009 issue of the Journal of Clinical Oncology.[1]
Reduced-intensity allogeneic stem cell transplants for patients with relapsed low- and high-grade lymphoma has been effective, potentially curative therapy. A previous study from the Fred Hutchinson Cancer Research Center reported a 45% three-year progression-free survival for 31 patients with relapsed DLBCL following reduced-intensity allogeneic stem cell transplants using a total body irradiation-based regimen.
The current study involved 48 patients with relapsed DLBCL. Thirty patients had de-novo disease and 18 had transformed follicular lymphoma. The median number of prior treatment regimens was five, and 69% had received a prior autologous transplant. The median age for this group of patients was 46 years. Patients in this study received a Campath® (alemtuzumab), Fludara® (fludarabine), and melphalan regimen. Thirty-two percent of patients relapsed, and 12 received donor lymphocytes with or without chemotherapy. Five of these obtained durable remissions. The progression-free survival at four years was 48%, and overall survival was 47%. Patients with chemotherapy-sensitive disease had better outcomes with an overall survival of 54%.
Comments: These data confirm that reduced-intensity allogeneic stem cell transplants can be curative for patients with relapsed DLBCL.
References:
[1] Thomson KJ, Morris EC, Bloor A, et al. Favorable long-term survival after reduced-intensity allogeneic transplantation for multiple-relapse aggressive non-Hodgkin’s lymphoma. Journal of Clinical Oncology. 2009;27:426-432.
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