Allogeneic stem cell transplantation in treatment of aggressive lymphomas: case series

To assess the outcome of allogeneic stem cell transplantation in patients with aggressive lymphoma.

Between 1991 and 2002, 22 patients with aggressive lymphoma in advanced phase of the disease underwent allogeneic stem cell transplantation at the Division of Hematology, Zagreb University Hospital Center. Seventeen patients received stem cells from the bone marrow. Eighteen patients underwent total body irradiation and received cyclophosphamide for conditioning, whereas the rest of the patients received busulfan and cyclophosphamide (n=2) or chemotherapeutic protocol combining carmustine, melphalan, etoposide, and cytarabine (BEAM regimen) (n=2). All patients received cyclosporin and short methotrexate for the prophylaxis of graft-versus-host disease (GVHD).

Three months after allotransplantation, 17 patients had complete remission, 3 patients had active disease, and the outcome in 2 patients was early death. Nine patients were alive and in complete remission for 4 to 124 months, whereas 13 patients died (8 because of disease progression and 3 because of GVHD and infection). The probability of overall survival at 4 years was 47%.

Allogeneic transplantation is an effective therapy for advanced aggressive lymphoma. Because of high treatment-related toxicity and mortality, prospective trials are needed to asses the best time when to apply this treatment.