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Allogeneic bone marrow transplantation in aggressive non‐Hodgkin's lymphoma (excluding Burkitt and lymphoblastic lymphoma): a series of 73 patients from the SFGM database
Author(s) -
Nathalie Dhédin,
Stéphane Giraudier,
Philippe Gaulard,
Hélène Esperou,
Norbert Ifrah,
Mauricette Michallet,
Noël Milpied,
Bernard Rio,
J Cahn,
Lysiane Molina,
JeanPhilippe Laporte,
François Guilhot,
Mathieu Kuentz
Publication year - 1999
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1999.01666.x
Subject(s) - medicine , lymphoma , transplantation , lymphoblastic lymphoma , population , surgery , immunology , immune system , environmental health , t cell
The place of allogeneic bone marrow transplantation (BMT) in the treatment of aggressive non‐Hodgkin's lymphoma (NHL) remains controversial. We conducted a retrospective study of French experience in allografting NHL between 1984 and 1994. To improve the homogeneity of the study population, cases of low‐grade, Burkitt and lymphoblastic NHL were excluded. 73 patients were included in the analysis. Median age at transplantation was 35 years (range 9–61 years); 64 patients were in stage IV and 45 had bone marrow involvement at diagnosis. At the time of transplantation, 46 patients had sensitive disease (25 in complete remission; CR). The overall survival (OS) and progression‐free survival (PFS) rates were 41% and 40% respectively at 5 years (median follow‐up of survivors 90 months). The probability of disease progression was 30% at 5 years, and only one relapse occurred after 15 months. 32 patients died of transplantation‐related complications. In multivariate analysis, pretransplant complete remission was the main factor associated with longer survival (OS at 60 months of 76% among the 25 patients in CR at transplant and of 23% among the 48 patients not in CR at transplant). Neither acute nor chronic graft‐versus‐host disease (GvHD) influenced the relapse rate. In conclusion, in this high‐risk population the overall results of allogeneic BMT were encouraging, despite a high transplant‐related mortality rate. We believe this procedure should be studied further in prospective controlled trials.