International Journal of Hematology

DOI: 10.1007/s12185-019-02748-1 Pages: 723-728

Successful outcome with reduced-intensity condition regimen followed by allogeneic hematopoietic stem cell transplantation for relapsed or refractory anaplastic large-cell lymphoma

1. National Kyushu Cancer Center, Department of Pediatrics

2. Yamaguchi University Graduate School of Medicine, Department of Pediatrics

3. St. Marianna University School of Medicine, Department of Pediatrics

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

5. Sapporo Hokuyu Hospital, Department of Pediatrics

6. Yamagata University Hospital, Department of Pediatrics

7. Kyushu University Graduate School of Medicine, Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences

8. Shimane University Hospital, Department of Oncology/Hematology

9. National Cancer Center Hospital, Department of Hematopoietic Stem Cell Transplantation

10. Asahikawa Medical University, Division of Gastroenterology and Hematology/Oncology Department of Medicine

11. Saitama Cancer Center, Department of Hematology

12. Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Department of Medical Oncology

13. Osaka City General Hospital, Department of Pediatric Hematology/Oncology

14. Osaka Women’s and Children’s Hospital, Department of Hematology/Oncology

15. Osaka University Graduate School of Medicine, Department of Pediatrics

16. Miyagi Children’s Hospital, Department of Hematology and Oncology

17. Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Division of Pediatrics

Correspondence to:
Reiji Fukano
Tel: +81-836-22-2258
Email: fukano.r@yamaguchi-u.ac.jp

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Abstract

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.

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