Allogeneic Stem Cell Transplantation in Treatment of Refractory/Relapsed Lymphomas

Abstract

Aim: To assess the outcome of allogeneic stem cell transplantation in patients with refractory/relapsed lymphoma. Methods: Between 2021 and 2023, 6 patients with refractory/relapsed (R/R) lymphoma underwent allogeneic stem cell transplantation at the Bone Marrow Transplant Department of Regional Institute of Oncology Iasi- 4 with Hodgkin lymphoma (HL), 1 with primary mediastinal large B-cell lymphoma (PMBCL) and 1 with Mycosis fungoides (MF). All patients received reduced intensity conditioning chemotherapy, combining Fludarabine, Busulfan or Melphalan. The prophylaxis of graft-versus-host-disease (GVHD) was made with Cyclophosphamide (n=4), Tacrolimus and Mycophenolate mofetil (n=5), Cyclosporine (n=1). Results: The post transplant evolution of the patients was marked by infectious complications (n=5), digestive mucositis (n=4) and viral reactivations (n=4). One patient with HL had acute cutaneous and hepatic graftversus-host disease(GVHD) and two had chronic hepatic and intestinal GVHD. Imaging evaluation by PETCT on day +100 shows a complete response in three patients with HL and progressive disease in the patient with PMBCL and one patient with HL. Conclusion: Despite the introduction of increasingly effective treatment options for R/R lymphoma, transplantation continues to play an important role in the management of these patients. Allogeneic transplantation is an effective therapy for advanced aggressive lymphoma, limited by treatment-related toxicity and mortality.