Allogenic stem cell transplantation in non-Hodgkin lymphoma

The authors looked at the outcomes for patients with non-Hodgkin lymphoma (NHL) who have undergone allogeneic stem cell transplantation. The study concluded that even patients with aggressive NHL should consider allogeneic stem cell transplantation. 

There are mutliple subtypes of non-Hodgkin lymphoma (NHL). Some subtypes are more aggressive than others. Some subtypes may be more or less sensitive to the effects of chemotherapy (treatment to kill cancer cells). Allogeneic stem cell transplantation (immature blood cells from a matched donor; allo-SCT) is an option for all subtypes of NHL that has progressed or relapsed.

One common side effect of allo-SCT is graft-versus-host disease (GVHD). GVHD involves the donated cells attacking the patient’s body. More research is needed on the effect of allo-SCT for young patients and patients with aggressive NHL. 

The medical records of 77 patients were reviewed. NHL subtypes included in this study were follicular lymphoma, marginal zone lymphoma, mantle cell lymphoma, peripheral T cell lymphoma or diffuse large B-cell lymphoma. All patients underwent an allo-SCT to treat their NHL. The average number of prior treatments was 3. The average length of follow-up was 23 months.

The 2-year overall survival rate (time from treatment to death from any cause) was 53.5%. The 2-year overall survival (OS) rate for patients less than 60 years old was 58%. This was significantly higher than the 2-year OS rate for patients older than 60 years (24%).

The 2-year overall survival rate for patients with aggressive NHL (47%) was not significantly different from that for patients with indolent (slow-growing) NHL (63%).

Of the 44 patients who died, the most common causes of death were GVHD (41%) and infections (25%).

The study concluded that while there are risks such as graft-versus-host disease, patients with aggressive NHL should still be considered for an allogeneic stem cell transplantation.