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Reduced-intensity hematopoietic stem-cell transplantation for malignant lymphoma: a retrospective survey of 112 adult patients in Japan
- Source :
- Bone Marrow Transplantation. 36:205-213
- Publication Year :
- 2005
- Publisher :
- Springer Science and Business Media LLC, 2005.
-
Abstract
- We conducted a nation-wide survey of 112 adult Japanese patients who underwent reduced-intensity stem cell transplantation (RIST) from 1999 to 2002. Underlying diseases included indolent (n=45), aggressive (n=58) and highly aggressive lymphomas (n=9). Median age of the patients was 49 years. A total of 40 patients (36%) had relapsed diseases after autologous stem cell transplantation and 36 patients (32%) had received radiotherapy. RIST regimens were fludarabine-based (n=95), low-dose total body irradiation-based (n=6) and others (n=11). Cumulative incidences of grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD were, respectively, 49 and 59%. Cumulative incidences of progression and progression-free mortality were 18 and 25%, respectively. With a median follow-up of 23.9 months, 3-year overall survival rates were 59%. A multivariate analysis identified three significant factors for progression, which are history of radiation (relative risk (RR) 3.45, confidential interval (CI) 1.12-10.0, P=0.03), central nervous system involvement (RR 6.25, CI 2.08-20.0, P=0.001) and development of GVHD (RR 0.28, CI 0.090-0.86, P=0.026). RIST may have decreased the rate of transplant-related mortality, and GVHD may have induced a graft-versus-lymphoma effect. However, whether or not these potential benefits can be directly translated into improved patient survival should be evaluated in further studies.
- Subjects :
- Adult
Male
Risk
medicine.medical_specialty
Time Factors
Lymphoma
medicine.medical_treatment
Graft vs Host Disease
Aggressive lymphoma
Hematopoietic stem cell transplantation
Gastroenterology
Disease-Free Survival
Autologous stem-cell transplantation
Japan
Internal medicine
medicine
Humans
Aged
Retrospective Studies
Transplantation
business.industry
Graft vs Tumor Effect
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Total body irradiation
medicine.disease
Fludarabine
Surgery
Treatment Outcome
Graft-versus-host disease
Multivariate Analysis
Female
business
Stem Cell Transplantation
medicine.drug
Subjects
Details
- ISSN :
- 14765365 and 02683369
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Bone Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....a370bb7da1e68968c26c4ca598345efb