Second Autologous Stem Cell Transplantation for Relapsed Lymphoma after a Prior Autologous Transplant

Sonali M. Smith, Koen van Besien, Jeanette Carreras, Asad Bashey, Mitchell S. Cairo, Cesar O. Freytes, Robert Peter Gale, Gregory A. Hale, Brandon Hayes-Lattin, Leona A. Holmberg, Armand Keating, Richard T. Maziarz, Philip L. McCarthy, Willis H. Navarro, Santiago Pavlovsky, Harry C. Schouten, Matthew Seftel, Peter H. Wiernik, Julie M. Vose, Hillard M. LazarusParameswaran Hari

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

We determined treatment-related mortality, progression-free survival (PFS), and overall survival (OS) after a second autologous HCT (HCT2) for patients with lymphoma relapse after a prior HCT (HCT1). Outcomes for patients with either Hodgkin lymphoma (HL, n = 21) or non-Hodgkin lymphoma (NHL, n = 19) receiving HCT2 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) were analyzed. The median age at HCT2 was 38 years (range: 16-61) and 22 (58%) patients had a Karnofsky performance score <90. HCT2 was performed >1 year after HCT1 in 82%. The probability of treatment-related mortality at day 100 was 11% (95% confidence interval [CI], 3%-22%). The 1-, 3-, and 5-year probabilities of PFS were 50% (95% CI, 34%-66%), 36% (95% CI, 21%-52%), and 30% (95% CI, 16%-46%), respectively. Corresponding probabilities of survival were 65% (95% CI, 50%-79%), 36% (95% CI, 22%-52%), and 30% (95% CI, 17%-46%), respectively. At a median follow-up of 72 months (range: 12-124 months) after HCT2, 29 patients (73%) have died, 18 (62%) secondary to relapsed lymphoma. The outcomes of patients with HL and NHL were similar. In summary, this series represents the largest reported group of patients with relapsed lymphomas undergoing SCT2 following failed SCT1, and with long-term follow-up. Our series suggests that SCT2 is feasible in patients relapsing after prior HCT1, with a lower treatment-related mortality than that reported for allogeneic transplant in this setting. HCT2 should be considered for patients with relapsed HL or NHL after HCT1 without alternative allogeneic stem cell transplant options.

Original languageEnglish (US)
Pages (from-to)904-912
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume14
Issue number8
DOIs
StatePublished - Aug 2008

Keywords

  • Hodgkin lymphoma
  • Non-Hodgkin lymphoma
  • Second autologous transplant

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Fingerprint Dive into the research topics of 'Second Autologous Stem Cell Transplantation for Relapsed Lymphoma after a Prior Autologous Transplant'. Together they form a unique fingerprint.

  • Cite this

    Smith, S. M., van Besien, K., Carreras, J., Bashey, A., Cairo, M. S., Freytes, C. O., Gale, R. P., Hale, G. A., Hayes-Lattin, B., Holmberg, L. A., Keating, A., Maziarz, R. T., McCarthy, P. L., Navarro, W. H., Pavlovsky, S., Schouten, H. C., Seftel, M., Wiernik, P. H., Vose, J. M., ... Hari, P. (2008). Second Autologous Stem Cell Transplantation for Relapsed Lymphoma after a Prior Autologous Transplant. Biology of Blood and Marrow Transplantation, 14(8), 904-912. https://doi.org/10.1016/j.bbmt.2008.05.021