Successful outcome with reduced-intensity condition regimen followed by allogeneic hematopoietic stem cell transplantation for relapsed or refractory anaplastic large-cell lymphoma
We report a retrospective analysis of 38 patients (age ≤ 30 years) who underwent allogeneic hematopoietic stem cell transplantation (allo-SCT) for relapsed or refractory anaplastic large-cell lymphoma (ALCL). Median follow-up for survivors after undergoing allo-SCT was 72 months (range, 35–96 months). Eight patients received reduced-intensity conditioning (RIC) regimens, including three patients with fludarabine plus melphalan-based regimens and five patients with fludarabine plus busulfan-based regimens. The remaining 30 patients received myeloablative conditioning (MAC) regimens. Median ages in the RIC and MAC groups were 24 and 15 years, respectively. The 5-year overall survival rates in the RIC and MAC groups were 100% and 49%, respectively (P = 0.018). The 5-year event-free survival rates in the RIC and MAC groups were 88% and 43%, respectively (P = 0.039). In the RIC group, four of the eight patients showed residual disease at allo-SCT, but all eight patients survived with complete remission (CR), including one patient with relapse. This result suggests that allo-SCT using the RIC regimen may be effective for relapsed or refractory ALCL in children, adolescents, and young adults, even in non-CR cases.
KeywordsAnaplastic large-cell lymphoma Hematopoietic stem cell transplantation Reduced-intensity conditioning Children Young adults
We wish to thank each of the clinicians, hospital administrators, and health center administrators who provided precise data via the registry of the Japan Society for Stem Cell Transplantation. We also wish to thank Yuki Yamashita for supporting the data analysis.
NF, TM, RK, TM, KK, RS, JS, and RF designed the research study; TF, MS, NM, TS, KO, MI, JI, YK, JI, YH, AS, and KT collected the data; RS and RF analyzed the data; and RF wrote the paper. All authors reviewed the manuscript.
Compliance with ethical standards
Conflict of interest
R. Suzuki reports personal fees from Bristol-Meyer Squib, Novartis Pharmaceuticals, Kyowa-Hakko Kirin, Chugai Pharmaceutical, Shionogi, Takeda Pharmaceutical, Meiji Seika Pharma, MSD, Otsuka Pharmaceutical, Sawai, Celgene, Sumitomo Dainippon Pharma, Eisai Pharmaceuticals, Alexion Pharma, Sano, Gilead Sciences, Abbvie Inc., Mundi Pharma, Jazz Pharma, Ono Pharmaceutical, and Janssen Pharmaceuticals, outside the submitted work. The other authors declare no relevant conflict of interest.
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