Ten-year follow-up of pediatric patients with non-hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation

Lisa Giulino-Roth, Rosanna Ricafort, Nancy A. Kernan, Trudy N. Small, Tanya M. Trippett, Peter G. Steinherz, Susan E. Prockop, Andromachi Scaradavou, Michelle Chiu, Richard J. O'Reilly, Farid Boulad

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19 Scopus citations

Abstract

Background: Autologous or allogeneic hematopoietic stem cell transplant (SCT) is often considered in patients with relapsed or refractory non-Hodgkin lymphoma (NHL) but there are limited data on the use of SCT for the treatment of NHL in the pediatric setting. Procedure: To evaluate the role of SCT for children with NHL, we reviewed 36 consecutive pediatric patients with NHL who underwent an allogeneic (n=21) or autologous (n=15) SCT at our institution between 1982 and 2004. Pathologic classification included: lymphoblastic lymphoma (n=12), Burkitt lymphoma (BL) (n=5), diffuse large B-cell lymphoma (n=4), anaplastic large cell lymphoma (ALCL) (n=13), peripheral T cell lymphoma (n=1), and undifferentiated NHL (n=1). Donor source for allogeneic-SCT recipients was an HLA-matched related donor (n=15), a matched unrelated donor (n=4), or a mismatched donor (related n=1; unrelated n=1). Twenty-eight patients (78%) had chemotherapy responsive disease at the time of transplant (either CR or PR). Results: Overall survival (OS) and disease-free survival (DFS) were 55% and 53% with a median follow-up of 9.75 years. Outcomes were similar in patients receiving autologous and allogeneic-SCT (DFS 53% in both groups). Patients with ALCL had a DFS of 76.9%. In contrast, of five patients transplanted for BL, none survived. DFS among patients with chemotherapy sensitive disease was 61%, compared with 25% among patients with relapsed/refractory disease (P=0.019). Conclusions: Allogeneic and autologous SCT offer the prospect of durable, disease-free survival for a significant proportion of pediatric patients with relapsed or refractory NHL. Survival is superior among patients with chemotherapy sensitive disease. Pediatr Blood Cancer 2013;60:2018-2024.

Original languageEnglish (US)
Pages (from-to)2018-2024
Number of pages7
JournalPediatric Blood and Cancer
Volume60
Issue number12
DOIs
StatePublished - Dec 1 2013

Keywords

  • Allogeneic stem cell transplant
  • Autologous stem cell transplant
  • Non-Hodgkin lymphoma
  • Pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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    Giulino-Roth, L., Ricafort, R., Kernan, N. A., Small, T. N., Trippett, T. M., Steinherz, P. G., Prockop, S. E., Scaradavou, A., Chiu, M., O'Reilly, R. J., & Boulad, F. (2013). Ten-year follow-up of pediatric patients with non-hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation. Pediatric Blood and Cancer, 60(12), 2018-2024. https://doi.org/10.1002/pbc.24722