Premium
Outcome of BEAM‐autologous and BEAM‐alemtuzumab allogeneic transplantation in relapsed advanced stage follicular lymphoma
Author(s) -
Ingram Wendy,
Devereux Stephen,
DasGupta Emma P.,
Russell Nigel H.,
Haynes Andrew P.,
Byrne Jennifer L.,
Shaw Bronwen E.,
McMillan Andrew,
Gonzalez Juan,
Ho Aloysius,
Mufti Ghulam J.,
Pagliuca Antonio
Publication year - 2008
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 - 10.1111/j.1365-2141.2008.07067.x
Subject(s) - medicine , alemtuzumab , follicular lymphoma , melphalan , etoposide , carmustine , survival rate , oncology , lymphoma , transplantation , gastroenterology , surgery , chemotherapy
Summary The role of haematopoietic stem cell transplantation (HSCT) in relapsed follicular lymphoma remains controversial. This study analysed 126 patients with relapsed, advanced stage follicular lymphoma who received BEAM (BCNU [carmustine], cytarabine, etoposide, melphalan)‐alemtuzumab allogeneic HSCT (BEAM‐allo) ( n = 44) or BEAM‐autologous HSCT (BEAM‐auto) ( n = 82). The BEAM‐allo group had a younger median age (48 years vs. 56 years, P < 0·001) but received a higher median number of therapies pretransplant ( P = 0·015) compared with the BEAM‐auto group. There was a higher non‐relapse mortality (NRM) in the BEAM‐allo group compared with the BEAM‐auto group at 1 year (20% vs. 2%, P = 0·001). Older age and heavily pretreated patients were associated with a higher NRM and poorer survival in the BEAM‐allo group. There was, however, a significantly lower relapse rate (20% vs. 43%, P = 0·01) at 3 years with BEAM‐alemtuzumab, with no relapses after 2 years, compared with a continued pattern of relapse in the autologous group. No difference in overall survival (OS) ( P = 0·99) or disease‐free survival (DFS) ( P = 0·90) was identified at 3 years, whereas a plateau in OS and DFS with crossing of the survival curves in favour of BEAM‐allo group was observed. Furthermore, the ability to re‐induce remissions with donor leucocytes provides additional benefit in favour of allogeneic HSCT.