Allogeneic hematopoetic stem cell transplantation after reduced intensity conditioning for patients with indolent or mantle cell lymphoma

Abstract

6628 Background: Allogeneic transplantation for Non-Hodkin Lymphoma ( NHL) is often associated with a high transplant related mortality. The aim of this retrospective single centre study was to analyse feasibility and efficacy of reduced intensity conditioning ( RIC) in patients with refractory or recurrent indolent and mantle cell NHL. Methods: From 11/99 to 5/2003 16 patients with refractory or relapsed NHL ( indolent n=8, mantle cell n=8) were transplanted after dose reduced conditioning ( Flu/Mel n=8, Flu/BEAM n=5, BEAM n=1, others n=2) with bone marrow ( n=3) or peripheral stem cells ( n=16) from a related ( n=9) or unrelated ( n=7) donor. Medium age was 46y ( 30–60y). GVHD prophylaxis consisted of cyclosporin A/ methotrexat ( n=15), cyclosporin A/MMF ( n=1) and anti thymocyte globulin ( ATG Freseniusn=16). 7 patients already relapsed prior to autologous transplantation. Results: 13 of 14 evaluable patients ( 93%) achieved a clinical complete remission ( CCR). With a medium follow up of 22 month ( 6–43 month) 10 patients ( 63%) are alive, seven of them ( 44%) still in CCR. 6 patients (37%)relapsed/ progressed within a median of 9 month ( 1–28 month) after transplantation. 3 patients developed grade II-IV GVHD. Severe grade III/IV GVHD was seen in 1 patient. 13 patients were evaluable for chronic GVHD. Two experienced limited GVHD. Extensive GVHD was seen in one patient.Transplant related mortality at one year was 19%. Conclusions: RIC is asociated with a low TRM, a high potency of remission induction and may lead to long lasting tumor control in patients with heavily pretreated indolent or mantle cell lymphoma. No significant financial relationships to disclose.