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Allogenic Versus Autologous Bone Marrow Transplantation

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  • BEN HAINES
    Blood 1997 Nov 15;90(10):4201-4205 Allogeneic Versus Autologous Bone Marrow Transplantation for Refractory and Recurrent Low-Grade Non-Hodgkin s Lymphoma.
    Message 1 of 1 , Nov 12, 1997
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      Blood 1997 Nov 15;90(10):4201-4205

      Allogeneic Versus Autologous Bone Marrow Transplantation for
      Refractory and Recurrent Low-Grade Non-Hodgkin's
      Lymphoma.

      Verdonck LF, Dekker AW, Lokhorst HM, Petersen EJ, Nieuwenhuis HK

      Department of Haematology, University Hospital Utrecht, The
      Netherlands.

      Patients with recurrent or refractory low-grade non-Hodgkin's lymphoma
      (NHL) are increasingly treated with myeloablative therapy and
      autologous stem cell transplantation. However, allogeneic bone marrow
      transplantation (BMT) is only sporadically performed in such patients.
      Therefore, we wish to compare treatment results of patients with
      recurrent or refractory low-grade NHL who underwent allogeneic BMT
      with those who underwent autologous BMT in our center. Twenty-eight
      patients were studied. The patients had received 2 to 5 lines of
      conventional chemotherapy before the BMT procedure. Eighteen
      patients, all with chemotherapy-sensitive disease at the time of
      transplantation, underwent autologous BMT and 10 patients, of
      whom 7 with chemotherapy-resistant disease at the time of
      transplantation, underwent allogeneic BMT.
      Furthermore, all allogeneic BMT patients had overt lymphoma infiltration of
      the BM at the time of transplantation. The conditioning regimen consisted
      of cyclophosphamide plus total body irradiation in all 28 patients. All
      allogeneic BMT patients achieved complete remission, 3 patients had a
      treatment-related death, and 7 patients are alive and disease-free with a
      median follow-up of 41 months. In contrast, none of the
      autologous BMT patients died of transplant-related complications.
      However, despite the fact that all autologous BMT patients had
      chemotherapy-sensitive disease and partial remission was converted to
      complete remission by the BMT procedure in 67% of them, only 3 of 18
      patients are alive and disease-free. The probability of relapse or
      disease-progression among allogeneic BMT patients was 0% compared
      with 83% for autologous BMT patients (P = .002). Progression-free
      survival rates 2 years after BMT were 68% for allogeneic BMT
      patients and 22% for autologous BMT patients (P = .049). Although the
      numbers of patients are small, this study suggests that allogeneic BMT
      offers a better chance for cure than autologous BMT for patients with
      poor-prognosis low-grade lymphoma, and the difference in relapse or
      disease progression is strongly suggestive for the existence of a
      graft-versus-low-grade lymphoma effect.

      PMID: 9354692
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