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Annals of Hematology

, Volume 91, Issue 6, pp 931–939 | Cite as

Allogeneic hematopoietic stem cell transplantation in patients with diffuse large B cell lymphoma relapsed after autologous stem cell transplantation: A GITMO study

  • Luigi RigacciEmail author
  • Bendetta Puccini
  • Anna Dodero
  • Pasquale Iacopino
  • Luca Castagna
  • Stefania Bramanti
  • Fabio Ciceri
  • Renato Fanin
  • Alessandro Rambaldi
  • Michele Falda
  • Giuseppe Milone
  • Stefano Guidi
  • Massimo Fabrizio Martelli
  • Patrizio Mazza
  • Rosi Oneto
  • Alberto Bosi
  • Gruppo Italiano Trapianto di Midollo Osseo (GITMO)
Original Article

Abstract

Patients who relapse after an autologous hematopoietic stem cell transplantation (SCT) have a very poor prognosis. We have retrospectively analyzed diffuse large B cell lymphoma patients who underwent an allo-SCT after an auto-SCT relapse reported in the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) database. From 1995 to 2008, 3449 autologous transplants were reported in the GITMO database. Eight hundred eighty-four patients relapsed or progressed after transplant; 165 patients, 19% of the relapsed patients, were treated with allo-transplant. The stem cell donor was related to the patient in 108 cases. A reduced intensity conditioning regimen was used in 116. After allo-SCT, 72 patients (43%) obtained a complete response and 9 obtained a partial response with an overall response rate of 49%; 84 patients (51%) experienced rapid progression of disease. Ninety-one patients died, 45 due to disease and 46 due to treatment-related mortality. Acute graft-versus-host disease was recorded in 57 patients and a chronic GvHD in 38 patients. With a median follow-up of 24 months (2–144) after allo, overall survival (OS) was 39%, and after a median of 21 months (2–138) after allo, progression-free survival (PFS) was 32%. Multivariate analysis indicated that the only factors affecting OS were status at allo-SCT, and those affecting PFS were status at allo-SCT and stem cell donor. This retrospective analysis shows that about one-fifth of patients with diffuse large B cell lymphoma who experience relapse after autologous transplantation may be treated with allogeneic transplantation. Moreover, the only parameter affecting either OS or PFS was the response status at the time of allo-SCT.

Keywords

Diffuse large B cell lymphoma Salvage therapy Autologous stem cell transplantation Allogeneic stem cell transplantation Reduced intensity conditioning regimen Graft versus lymphoma 

Notes

Acknowledgments

The following Italian GITMO centers have contributed to the study: CIC 232 Roma, Foà Robin; CIC 788 Ancona, Leoni Pietro; CIC 649 Bari, Liso Vincenzo; CIC 544 Monza, Pioltelli Pietro; CIC 526 S.Giovanni Rotondo, Cascavilla Nicola; CIC 392 Palermo, Scimé Rosanna; CIC 245 Parma, Rizzoli Vittorio; CIC 139 Genova, Ballestrero Alberto; CIC 797 Vicenza, Raimondi Roberto; CIC 756 Roma, Arcese William; CIC 692 Palermo, Musso Maurizio; CIC 623 Verona, Benedetti Fabio; CIC 378 Torino, Guerrasio Angelo; CIC 287 Roma, Majolino Ignazio; CIC 265 Milano, Lambertenghi Deliliers Giorgio; CIC 240 Bologna, Baccarani Michele; CIC 217 Genova, Bacigalupo Andrea; CIC 132 Pisa, Petrini Mario; CIC 987 Genova, Carella Angelo Michele; CIC 825 Alessandria, Levis Alessandro; CIC 811 Cagliari, La Nasa Giorgio; CIC 660 Reggio Emilia, Merli Francesco; CIC 543 Modena, Narni Franco; CIC 321 Siena, Lauria Francesco; CIC 299 Bolzano, Cortelazzo Sergio; CIC 870 Sassari, Longinotti Maurizio; CIC 861 Potenza, Olivieri Attilio; CIC 795 Pisa, Favre Claudio; CIC 789 Avellino, Cantore Nicola; CIC 771 Pavia, Da Prada Gian Antonio; CIC 766 Napoli, Selleri Carmine; CIC 696 Torino, Bruno Benedetto; CIC 331 Milano, Martinelli Giovanni; CIC 307 Roma, Leone Giuseppe; CIC 248 Pescara, Di Bartolomeo Paolo; CIC 226 Cremona, Morandi Sergio; and CIC 163 Piacenza, Vallisa Daniele.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Luigi Rigacci
    • 1
    Email author
  • Bendetta Puccini
    • 1
  • Anna Dodero
    • 2
  • Pasquale Iacopino
    • 3
  • Luca Castagna
    • 4
  • Stefania Bramanti
    • 4
  • Fabio Ciceri
    • 5
  • Renato Fanin
    • 6
  • Alessandro Rambaldi
    • 7
  • Michele Falda
    • 8
  • Giuseppe Milone
    • 9
  • Stefano Guidi
    • 1
  • Massimo Fabrizio Martelli
    • 10
  • Patrizio Mazza
    • 11
  • Rosi Oneto
    • 12
  • Alberto Bosi
    • 1
  • Gruppo Italiano Trapianto di Midollo Osseo (GITMO)
  1. 1.Division of Hematology and Bone Marrow TransplantationAzienda Ospedaliera Universitaria CareggiFlorenceItaly
  2. 2.Division of Hematology and Bone Marrow TransplantationIstituto Nazionale dei TumoriMilanItaly
  3. 3.Centro Trapianti Midollo OsseoAzienda Ospedaliera Bianchi-Melacrino-MorelliReggio CalabriaItaly
  4. 4.Department of Oncology and HematologyIstituto Clinico HumanitasRozzanoItaly
  5. 5.Hematology and BMT UnitSan Raffaele Scientific InstituteMilanItaly
  6. 6.Division of Hematology and Bone Marrow TransplantationUniversity of UdineUdineItaly
  7. 7.Divisione di EmatologiaOspedali RiunitiBergamoItaly
  8. 8.Division of HematologySan Giovanni Battista HospitalTurinItaly
  9. 9.Division of Hematology and BM TransplantationOspedale FerrarottoCataniaItaly
  10. 10.Institute of HematologyUniversity of PerugiaPerugiaItaly
  11. 11.Struttura Complessa di EmatologiaAzienda Ospedaliera SS.AnnunziataTarantoItaly
  12. 12.Italian National BMT Registry-GITMOOspedale San MartinoGenovaItaly

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