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Query: UNIPROT:Q06643 (
non-Hodgkin's lymphoma
)
11,307
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
In patients with refractory lymphoma, we tested the hypothesis that high-dose chemotherapy (BEAM) without stem cell support followed by a reduced intensity (
RIC
) allogeneic transplant with fludarabine and 2 Gy TBI 28 days later results in tumor debulking and establishment of a graft vs lymphoma effect, with acceptable toxicity. In a pilot protocol we treated 10 patients, 22-62 (median 47) years of age with high-risk or refractory Hodgkin's or
non-Hodgkin's lymphoma
. Donors were HLA identical siblings (eight) or unrelated volunteers. None died during the neutropenic phase after BEAM which lasted up to the
RIC
HSCT. The duration of neutropenia was 31-43 (median 36) days. All patients engrafted and nine achieved CR. All developed acute GvHD (median grade III) and all patients at risk developed chronic GvHD. Three patients died of GvHD. One relapsed and six patients are in continuous CR 10-32 (median 15) months after HSCT. This approach appears feasible and results in a high response rate. Neutropenia duration is of concern. It remains to be tested whether separation of debulking chemotherapy and induction of allogeneic effects confers an advantage.
...
PMID:High-dose chemotherapy using BEAM for tumor debulking without stem cell support followed by early allogeneic reduced intensity conditioning transplantation to induce a graft-versus-lymphoma effect in patients with high risk or refractory lymphoma. 1506 93
The effectiveness of reduced-intensity conditioning allogeneic stem cell transplantation (allo-
RIC
) compared with high-dose chemotherapy followed by autologous stem cell transplantation (auto-SCT) in Hodgkin's disease (HD) and in
non-Hodgkin's lymphoma
(
NHL
) patients remains poorly defined. The purpose of the study was to demonstrate the usefulness of auto-SCT or allo-SCT, employing a
RIC
regimen in refractory or relapsed
NHL
or HD patients. We analyzed the outcome of 71 patients with advanced disease. Twenty-three
NHL
and 14 HD patients received an allo-
RIC
using fludarabine, cyclophosphamide, and low-dose busulfan as the conditioning regimen. Sixteen
NHL
and 18 HD patients received auto-SCT using cyclophosphamide and etoposide as conditioning regimen. All hematopoietic stem cells products were not cryopreserved and the majority of grafts were done on an outpatient basis, including conditioning and post-stem cell infusion care (auto-SCT, 62% and allo-
RIC
procedure, 91%). The median OS was 45.5 months for the allo-
RIC
recipients and 53.3 months for auto-SCT recipients. Acute/chronic GVHD incidence in
NHL
and HL groups was 38%/31% and 14%/7%, respectively. We found no significant difference in overall survival between allo-
RIC
group and auto-SCT group for
NHL
patients (P = 0.43) but better OS was observed for auto-SCT group than for allo-SCT group in HL patients (P < 0.001). The relapse rate was higher in autografted patients, both in
NHL
and HD. Both auto-SCT and allo-
RIC
appear to be valid treatments for poor-risk patients with relapsed or refractory lymphoma who could not otherwise be cured with conventional salvage regimens.
...
PMID:Outpatient reduced-intensity allogeneic stem cell transplantation for patients with refractory or relapsed lymphomas compared with autologous stem cell transplantation using a simplified method. 2049 Jul 94