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Title of Journal: Ann Hematol

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Abbravation: Annals of Hematology

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Springer-Verlag

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DOI

10.1002/clc.20195

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1432-0584

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Longterm results of autologous stem cell transpla

Authors: David Nachbaur Hildegard T Greinix Elisabeth Koller Otto Krieger Werner Linkesch Hedwig Kasparu Michael Pober Wolfgang Hinterberger Hubert Hausmaninger Max Heistinger Ernst Ulsperger Susanne Karlhuber Wolfgang Schwinger Beate Lindner
Publish Date: 2005/02/23
Volume: 84, Issue: 7, Pages: 462-473
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Abstract

Between 1990 and 2001 68 patients with advanced Hodgkin’s disease HD and 86 patients classified as low/intermediategrade B nonHodgkin’s lymphoma NHL were reported to the Austrian Stem Cell Transplantation Registry ASCTR Following autologous stem cell transplantation SCT for HD overall survival was 56 95 confidence interval CI 40–72 with a disease/progressionfree survival of 49 reaching a plateau at 5 years Using multivariate Cox regression analysis BEAM conditioning carmustine cytarabine etoposide and melphalan was predictive for favourable outcome better disease/progressionfree survival and a significantly lower risk for relapse The cumulative incidence of relapse was 30 even for patients in complete remission at time of SCT The cumulative risk for developing a secondary malignancy increased continuously over time achieving 20 at 7 years and 46 at 10 years with previous radiotherapy as the only risk factor in the multivariate analysis Overall survival for NHL patients was 45 95 CI 26–64 with a disease/progressionfree survival of 26 at 7 years In the multivariate Cox regression analysis stage of disease at time of SCT was the most powerful parameter for overall survival disease/progressionfree survival and relapse Mantle cell lymphoma greater than or equal to three lines of previous therapy and a conditioning regimen other than BEAM were also predictive for death The main reason for treatment failure was relapse cumulative incidence 54–75 Because of the high risk of relapse/progression in both disease categories and the additional high rate of second malignancies in HD patients allogeneic stem cells should be considered a valuable alternative for selected patients The efficacy of allotransplantation following reducedintensity conditioning should be tested in randomised trials

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