Premium
Ten‐year follow‐up of pediatric patients with non‐hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation
Author(s) -
GiulinoRoth Lisa,
Ricafort Rosanna,
Kernan Nancy A.,
Small Trudy N.,
Trippett Tanya M.,
Steinherz Peter G.,
Prockop Susan E.,
Scaradavou Andromachi,
Chiu Michelle,
O'Reilly Richard J.,
Boulad Farid
Publication year - 2013
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24722
Subject(s) - medicine , lymphoma , chemotherapy , transplantation , lymphoblastic lymphoma , hematopoietic stem cell transplantation , anaplastic large cell lymphoma , gastroenterology , autologous stem cell transplantation , refractory (planetary science) , oncology , surgery , immunology , t cell , physics , immune system , astrobiology
Background Autologous or allogeneic hematopoietic stem cell transplant (SCT) is often considered in patients with relapsed or refractory non‐Hodgkin lymphoma (NHL) but there are limited data on the use of SCT for the treatment of NHL in the pediatric setting. Procedure To evaluate the role of SCT for children with NHL, we reviewed 36 consecutive pediatric patients with NHL who underwent an allogeneic (n = 21) or autologous (n = 15) SCT at our institution between 1982 and 2004. Pathologic classification included: lymphoblastic lymphoma (n = 12), Burkitt lymphoma (BL) (n = 5), diffuse large B‐cell lymphoma (n = 4), anaplastic large cell lymphoma (ALCL) (n = 13), peripheral T cell lymphoma (n = 1), and undifferentiated NHL (n = 1). Donor source for allogeneic‐SCT recipients was an HLA‐matched related donor (n = 15), a matched unrelated donor (n = 4), or a mismatched donor (related n = 1; unrelated n = 1). Twenty‐eight patients (78%) had chemotherapy responsive disease at the time of transplant (either CR or PR). Results Overall survival (OS) and disease‐free survival (DFS) were 55% and 53% with a median follow‐up of 9.75 years. Outcomes were similar in patients receiving autologous and allogeneic‐SCT (DFS 53% in both groups). Patients with ALCL had a DFS of 76.9%. In contrast, of five patients transplanted for BL, none survived. DFS among patients with chemotherapy sensitive disease was 61%, compared with 25% among patients with relapsed/refractory disease ( P = 0.019). Conclusions Allogeneic and autologous SCT offer the prospect of durable, disease‐free survival for a significant proportion of pediatric patients with relapsed or refractory NHL. Survival is superior among patients with chemotherapy sensitive disease. Pediatr Blood Cancer 2013;60:2018–2024. © 2013 Wiley Periodicals, Inc.