• Richard T Doocey, Cynthia L Toze, Joseph M Connors, Thomas J Nevill, Randy D Gascoyne, Michael J Barnett, Donna L Forrest, Donna E Hogge, Julye C Lavoie, Stephen H Nantel, John D Shepherd, Heather J Sutherland, Nicholas J Voss, Clayton A Smith, and Kevin W Song.
• Division of Hematology, Leukemia/Bone Marrow Transplant Program of British Columbia, The Vancouver Hospital and Health Science Centre, Vancouver, BC, Canada.
• Br. J. Haematol. 2005 Oct 1; 131 (2): 223-30.

AbstractForty-four patients with relapsed or refractory aggressive histology non-Hodgkin lymphoma (NHL) (diffuse large B cell, n = 23; peripheral T cell, n = 5; transformed B cell, n = 16) proceeded to allogeneic stem cell transplant (allo-SCT) between 1987 and 2003. Median age at transplant was 40 years (range 19-56 years). At the time of transplant, 35 were chemosensitive and nine were chemorefractory. Thirty-three patients had matched sibling donors and 11 had unrelated donors. Forty-two patients (95%) received radiation-based conditioning regimens. Event-free survival (EFS) and overall survival (OS) at 5 years was 43% [95% confidence interval (CI): 27-58%] and 48% (95% CI: 32-63%) respectively. Treatment-related mortality was 25% at 1 year. Grade III-IV acute graft-versus-host disease (GVHD) was the only significant variable affecting OS and EFS, and had a negative impact. Chronic GVHD did not influence survival. Lymphoma relapse <12 months after initial therapy predicted for increased risk of relapse post-transplant (P = 0.02). Patients with chemorefractory lymphoma were not at increased risk of relapse (P = 0.20) with four of nine patients remaining alive without disease 12-103 months post-transplant. In conclusion, allo-SCT for relapsed or refractory aggressive histology NHL results in long-term EFS and OS of 40-50%. Patients with chemorefractory disease can have a durable remission post-transplant.

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