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 Blood, 1 March 2004, Vol. 103, No. 5, pp. 1955-1960.
Prepublished online as a Blood First Edition Paper on November 6, 2003; DOI 10.1182/blood-2003-03-0937.

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TRANSPLANTATION

Unrelated bone marrow transplantation for non-Hodgkin lymphoma: a study from the Japan Marrow Donor Program

Koji Izutsu, Yoshinobu Kanda, Hitoshi Ohno, Hiroshi Sao, Hiroyasu Ogawa, Yasushi Miyazaki, Keisei Kawa, Yoshihisa Kodera, Shunichi Kato, Yasuo Morishima, and Hisamaru Hirai

From the Department of Cell Therapy and Transplantation Medicine, University of Tokyo, Japan; Department of Hematology & Oncology, Graduate School of Medicine, Kyoto University, Japan; Department of Hematology, Meitetsu Hospital, Nagoya, Japan; Department of Molecular Medicine, Osaka University Graduate School of Medicine, Suita, Japan; Department of Hematology, Molecular Medicine Unit, Nagasaki University School of Medicine, Japan; Department of Pediatrics, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan; Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Japan; Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan; and Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan.

There is little information available regarding the outcome of unrelated bone marrow transplantation (BMT) for non-Hodgkin lymphoma (NHL). Therefore, we retrospectively analyzed the data of 124 patients who underwent unrelated BMT through the Japan Marrow Donor Program (JMDP) between July 1992 and August 2001. The overall survival (OS), progression-free survival (PFS), cumulative incidences of disease progression, and nonprogression mortality at 3 years after BMT were 49.7%, 42.6%, 24.5%, and 32.9%, respectively, with a median follow-up duration of 565 days among survivors. The incidence of grades II-IV acute graft-versus-host disease (GVHD) was 40.9%. Recipient age, previous history of autologous transplantation, and chemosensitivity at transplantation were independent prognostic factors for OS and PFS. The development of grades II-IV acute GVHD was associated with lower incidence of disease progression after transplantation, which suggested the existence of a graft versus lymphoma effect. Unrelated BMT should be considered as a treatment option for patients with high-risk NHL without an HLA-matched related donor.


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