Reduced intensity allogeneic stem cell transplantation for follicular lymphoma relapsing after an autologous transplant achieves durable long term disease control. An analysis from the Lymphoma Working Party Of the EBMT
Menée dans plusieurs pays européens auprès de 183 participants (âge médian : 45 ans), cette étude de cohorte rétrospective analyse l'efficacité d'une greffe allogénique de cellules souches hématopoïétiques à intensité réduite pour traiter des patients atteints d'un lymphome folliculaire récidivant après une première greffe autologue
Background : Patients with follicular lymphoma (FL) relapsing after an autologous transplant (autoSCT) may be treated with a variety of therapies including a reduced intensity allogeneic transplant (RICalloSCT). We conducted a retrospective analysis of a large cohort of patients undergoing RICalloSCT for FL in this setting. Patients and Methods : 183 patients, median age 45 years (range 21-69), had undergone an autoSCT at a median of 30 months prior to the RICalloSCT. Before the RICalloSCT they had received a median of 4 lines (range 3-10) of therapy and 81% of patients had chemosensitive disease and 16% had chemoresistant disease. Grafts were donated from sibling (47%) or unrelated donors (53%). Results : With a median follow up of 59 months the non-relapse mortality (NRM) was 27% at 2 years. The median remission duration post autoSCT and RICalloSCT were 14 and 43 months respectively. The 5 year relapse/progression rate, progression free survival (PFS) and overall survival (OS) were 16%, 48% and 51% respectively and were associated with age and disease status at RICalloSCT. Conclusion : This data suggests that a RICalloSCT is an effective salvage strategy in patients with FL recurring after a prior autoSCT and might overcome the poor prognostic impact of early relapse after autoSCT.