International Journal of Hematology

DOI: 10.1007/s12185-019-02608-y Pages: 483-490

Hematopoietic stem cell transplantation in children and adolescents with relapsed or refractory B-cell non-Hodgkin lymphoma

1. Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Department of Pediatrics

2. Sapporo Hokuyu Hospital, Department of Pediatrics

3. Nagoya University Graduate School of Medicine, Japanese Data Center for Hematopoietic Cell Transplantation, Department of Healthcare Administration

4. Kanagawa Children’s Medical Center, Department of Hematology

5. Shimane University Hospital, Department of Oncology/Hematology

6. Tohoku University Graduate School of Medicine, Department of Pediatrics

7. Osaka Medical Center and Research Institute for Maternal and Child Health, Department of Hematology/Oncology

8. Saitama Children’s Medical Center, Department of Hematology/Oncology

9. Sapporo Medical University School of Medicine, Department of Pediatrics

10. Kanagawa Children’s Medical Center, Division of Hemato-Oncology/Regenerative Medicine

11. Hiroshima University, Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine

12. Pediatrics, Osaka University Graduate School of Medicine

13. Japanese Red Cross Nagoya First Hospital, Department of Hematology and Oncology, Children’s Medical Center

14. Shimane University Hospital Cancer Center, Department of Oncology and Hematology

15. Yamagata University School of Medicine, Department of Pediatrics

Correspondence to:
Naoto Fujita
Tel: +81-82-241-3111
Email: nfujita@hiroshima-med.jrc.or.jp

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Abstract

We undertook a retrospective study using the national registry data of hematopoietic stem cell transplantation (HSCT) in Japan to investigate the effect of graft source, particularly autologous or allogeneic tissue, on the treatment outcome in patients aged less than 18 years with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Survival analysis was conducted on 31 autologous HSCT (auto-HSCT) and 48 allogeneic HSCT (allo-HSCT) recipients between 1990 and 2013. The 5-year survival rates were significantly lower for allo-HSCT compared to auto-HSCT recipients (32% vs. 55%; P = 0.036). Multivariate analysis of survival rates identified allogeneic graft, Burkitt histology, and lack of response to chemotherapy as poor prognostic factors for survival. The cumulative incidence of treatment-related mortality (TRM) was significantly higher in allo-HSCT compared to auto-HSCT recipients (P = 0.017), explaining the difference in survival rates. In patients with Burkitt lymphoma (BL), overall survival was significantly inferior in the group of patients undergoing HSCT within 12 months from the initial diagnosis (P = 0.039). These data indicate that treatment outcomes for HSCT in children and adolescents with B-NHL were better in autograft recipients, suggesting that greater attention should be paid to the risk of TRM, especially after allografts, for patients with BL.

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