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Blood, 1 July 2006, Vol. 108, No. 1, pp. 382-389.
Prepublished online as a Blood First Edition Paper on March 7, 2006; DOI 10.1182/blood-2005-02-0596.


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TRANSPLANTATION

Myeloablative allogeneic hematopoietic stem cell transplantation for non-Hodgkin lymphoma: a nationwide survey in Japan

Sung-Won Kim, Tetsuya E. Tanimoto, Noriyuki Hirabayashi, Seiichi Goto, Masahiro Kami, Satoshi Yoshioka, Toshiki Uchida, Kenji Kishi, Yuji Tanaka, Akio Kohno, Masaharu Kasai, Masakazu Higuchi, Masanobu Kasai, Shin-ichiro Mori, Takahiro Fukuda, Koji Izutsu, Hiroshi Sao, Takayuki Ishikawa, Tatsuo Ichinohe, Kengo Takeuchi, Kinuko Tajima, Ryuji Tanosaki, Mine Harada, Shuichi Taniguchi, Kensei Tobinai, Tomomitsu Hotta, and Yoichi Takaue

From the Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan; the Department of Hematology, Tottori University Hospital, Tottori, Japan; the Department of Internal Medicine, Nagoya Daini Red Cross Hospital, Nagoya, Japan; the Department of Hematology/Oncology, Kyoto University Hospital, Kyoto, Japan; the Division of Hematology, Tokai University Hospital, Isehara, Japan; the Department of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan; the Department of Hematology and Oncology, JA Aichi Showa Hospital, Konan, Japan; the Department of Internal Medicine, Sapporo Hokuyu Hospital, Sapporo, Japan; the Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan; the Department of Cell Therapy and Transplantation Medicine, University of Tokyo, Tokyo, Japan; the Department of Hematology, Meitetsu Hospital, Nagoya, Japan; the Department of Pathology, Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan; the First Department of Internal Medicine (Medicine and Biosystemic Science), Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan; and the Department of Hematology, Toranomon Hospital, Tokyo, Japan.

We retrospectively surveyed the data of 233 patients who underwent myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) for non-Hodgkin lymphoma (NHL). Donors were HLA-matched relatives in 154 patients (66%) or unrelated volunteers in 60 (26%). Ninety patients (39%) were in complete remission. One hundred ninety-three (83%) received a total body irradiation (TBI)-based regimen, and 40 (17%) received a non-TBI-based regimen. Acute graft-versus-host disease (GVHD) occurred in 155 (67%) of the 233 evaluable patients; grade II to IV in 90 (39%), and grade III to IV in 37 (16%). Treatment-related mortality (TRM) was observed in 98 patients (42%), and 68% of them were related to GVHD. In a multivariate analysis, chemoresistance, prior autograft, and chronic GVHD were identified as adverse prognostic factors for TRM. Relapse or progression of lymphoma was observed in 21%. The 2-year overall survival rates of the patients with indolent (n = 38), aggressive (n = 111), and lymphoblastic lymphoma (n = 84) were 57%, 42%, and 41%, respectively. In a multivariate analysis, chemoresistance, prior autograft, and prior radiotherapy were identified as adverse prognostic factors for overall survival. Although myeloablative allo-HSCT represents an effective therapeutic option for patients with NHL, more work is still needed to decrease TRM and relapse. (Blood. 2006;108:382-389)


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N. Schmitz, P. Dreger, B. Glass, and A. Sureda
Allogeneic transplantation in lymphoma: current status
Haematologica, November 1, 2007; 92(11): 1533 - 1548.
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