There are few treatment options for patients with non-Hodgkin lymphoma (NHL) who experienced progression after high-dose chemotherapy (HDC) with autologous stem cell transplantation (auto-SCT). The role of allogeneic stem cell transplantation (allo-SCT) in these patients has not been clarified yet. In this study, we report clinical outcomes of allo-SCT in patients with NHL who experienced progression after HDC with auto-SCT. Patients were enrolled from seven hospitals in Korea. A total of 38 patients were included: 18 patients (47.4%) underwent myeloablative conditioning and 20 patients (52.6%) reduced intensity conditioning. Overall response rate was 73.3%. Median event-free survival was 6.3 months. Median overall survival (OS) was 19.0 months. Estimated 5-year survival rate was 35.0%. Acute graft-versus-host disease developed in 13 patients (34.2%). Transplant-related mortality (TRM) was 21.1% (eight patients). Ann Arbor stage (p = 0.022), performance status (p < 0.001), and baseline serum albumin level (p = 0.010) were significant risk factors for OS. Performance status (p = 0.022) was a significant risk factor for TRM. Eight patients with persistent or progressive disease received donor lymphocyte infusion, and two of them achieved complete remission. In conclusion, despite high TRM, allo-SCT is a viable option for patients with NHL who underwent progression after HDC with auto-SCT.
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Acknowledgments The authors wish to acknowledge the efforts of Ms. Eun Mi Kim and Ms. Su Jin Kim in the Seoul National University Hospital and Ms. Yoonjung Lee in the Severance Hospital for coordinating the procedure of transplantation. This study was supported by a grant of the Korea Health 21 R&D project, Ministry of Health and Welfare, Korea (A030001) and a grant of the Korea Health 21 R&D project, Ministry for Health and Welfare, Korea (A084783).
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