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

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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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References

  1. Fukano R, Mori T, Kobayashi R, Mitsui T, Fujita N, Iwasaki F, et al. Haematopoietic stem cell transplantation for relapsed or refractory anaplastic large cell lymphoma: a study of children and adolescents in Japan. Br J Haematol. 2015;168(4):557–63.

    Article  Google Scholar 

  2. Yaniv I, Stein J, Party EPW. Reduced-intensity conditioning in children: a reappraisal in 2008. Bone Marrow Transplant. 2008;41(Suppl 2):S18–22.

    Article  Google Scholar 

  3. Giralt S, Ballen K, Rizzo D, Bacigalupo A, Horowitz M, Pasquini M, et al. Reduced-intensity conditioning regimen workshop: defining the dose spectrum Report of a workshop convened by the center for international blood and marrow transplant research. Biol Blood Marrow Transplant. 2009;15(3):367–9.

    Article  Google Scholar 

  4. Ohta H, Kusuki S, Yoshida H, Sato E, Hashii Y, Ozono K. Allogeneic hematopoietic stem cell transplantation with reduced intensity conditioning for a child with recurrent anaplastic large cell lymphoma. Int J Hematol. 2010;92(1):190–3.

    Article  Google Scholar 

  5. Luger SM, Ringden O, Zhang MJ, Perez WS, Bishop MR, Bornhauser M, et al. Similar outcomes using myeloablative vs reduced-intensity allogeneic transplant preparative regimens for AML or MDS. Bone Marrow Transplant. 2012;47(2):203–11.

    Article  CAS  Google Scholar 

  6. Bacigalupo A. Third EBMT/AMGEN Workshop on reduced-intensity conditioning allogeneic haemopoietic stem cell transplants (RIC-HSCT), and panel consensus. Bone Marrow Transplant. 2004;33(7):691–6.

    Article  CAS  Google Scholar 

  7. Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the intensity of conditioning regimens: working definitions. Biol Blood Marrow Transplant. 2009;15(12):1628–33.

    Article  Google Scholar 

  8. Strullu M, Thomas C, Le Deley MC, Chevance A, Kanold J, Bertrand Y, et al. Hematopoietic stem cell transplantation in relapsed ALK + anaplastic large cell lymphoma in children and adolescents: a study on behalf of the SFCE and SFGM-TC. Bone Marrow Transplant. 2015;50(6):795–801.

    Article  CAS  Google Scholar 

  9. Crocchiolo R, Esterni B, Castagna L, Furst S, El-Cheikh J, Devillier R, et al. Two days of antithymocyte globulin are associated with a reduced incidence of acute and chronic graft-versus-host disease in reduced-intensity conditioning transplantation for hematologic diseases. Cancer. 2013;119(5):986–92.

    Article  CAS  Google Scholar 

  10. Russell JA, Turner AR, Larratt L, Chaudhry A, Morris D, Brown C, et al. Adult recipients of matched related donor blood cell transplants given myeloablative regimens including pretransplant antithymocyte globulin have lower mortality related to graft-versus-host disease: a matched pair analysis. Biol Blood Marrow Transplant. 2007;13(3):299–306.

    Article  CAS  Google Scholar 

  11. Devillier R, Furst S, El-Cheikh J, Castagna L, Harbi S, Granata A, et al. Antithymocyte globulin in reduced-intensity conditioning regimen allows a high disease-free survival exempt of long-term chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2014;20(3):370–4.

    Article  CAS  Google Scholar 

  12. Corradini P, Dodero A, Zallio F, Caracciolo D, Casini M, Bregni M, et al. Graft-versus-lymphoma effect in relapsed peripheral T-cell non-Hodgkin’s lymphomas after reduced-intensity conditioning followed by allogeneic transplantation of hematopoietic cells. J Clin Oncol. 2004;22(11):2172–6.

    Article  Google Scholar 

  13. Woessmann W, Zimmermann M, Lenhard M, Burkhardt B, Rossig C, Kremens B, et al. Relapsed or refractory anaplastic large-cell lymphoma in children and adolescents after Berlin-Frankfurt-Muenster (BFM)-type first-line therapy: a BFM-group study. J Clin Oncol. 2011;29(22):3065–71.

    Article  Google Scholar 

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Acknowledgements

We wish to thank each of the clinicians, hospital administrators, and health center administrators who provided precise data via the registry of the Japan Society for Stem Cell Transplantation. We also wish to thank Yuki Yamashita for supporting the data analysis.

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Authors and Affiliations

  1. Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan

    Reiji Fukano & Jiro Inagaki

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

    Reiji Fukano

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

    Tetsuya Mori

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

    Naoto Fujita

  5. Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan

    Ryoji Kobayashi

  6. Department of Pediatrics, Yamagata University Hospital, Yamagata, Japan

    Tetsuo Mitsui

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

    Koji Kato

  8. Department of Oncology/Hematology, Shimane University Hospital, Izumo, Japan

    Ritsuro Suzuki & Junji Suzumiya

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

    Takahiro Fukuda

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

    Motohiro Shindo

  11. Department of Hematology, Saitama Cancer Center, Ina, Japan

    Nobuo Maseki

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

    Tatsu Shimoyama

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

    Keiko Okada

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

    Masami Inoue

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

    Yoshiko Hashii

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

    Atsushi Sato

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

    Ken Tabuchi

Authors
  1. Reiji Fukano
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  2. Tetsuya Mori
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  3. Naoto Fujita
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  4. Ryoji Kobayashi
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  5. Tetsuo Mitsui
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  6. Koji Kato
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  7. Ritsuro Suzuki
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  8. Junji Suzumiya
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  9. Takahiro Fukuda
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  10. Motohiro Shindo
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  11. Nobuo Maseki
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  12. Tatsu Shimoyama
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  13. Keiko Okada
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  14. Masami Inoue
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  15. Jiro Inagaki
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  16. Yoshiko Hashii
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  17. Atsushi Sato
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  18. Ken Tabuchi
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Contributions

NF, TM, RK, TM, KK, RS, JS, and RF designed the research study; TF, MS, NM, TS, KO, MI, JI, YK, JI, YH, AS, and KT collected the data; RS and RF analyzed the data; and RF wrote the paper. All authors reviewed the manuscript.

Corresponding author

Correspondence to Reiji Fukano.

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Conflict of interest

R. Suzuki reports personal fees from Bristol-Meyer Squib, Novartis Pharmaceuticals, Kyowa-Hakko Kirin, Chugai Pharmaceutical, Shionogi, Takeda Pharmaceutical, Meiji Seika Pharma, MSD, Otsuka Pharmaceutical, Sawai, Celgene, Sumitomo Dainippon Pharma, Eisai Pharmaceuticals, Alexion Pharma, Sano, Gilead Sciences, Abbvie Inc., Mundi Pharma, Jazz Pharma, Ono Pharmaceutical, and Janssen Pharmaceuticals, outside the submitted work. The other authors declare no relevant conflict of interest.

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Fukano, R., Mori, T., Fujita, N. et al. Successful outcome with reduced-intensity condition regimen followed by allogeneic hematopoietic stem cell transplantation for relapsed or refractory anaplastic large-cell lymphoma. Int J Hematol 110, 723–728 (2019). https://doi.org/10.1007/s12185-019-02748-1

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  • DOI: https://doi.org/10.1007/s12185-019-02748-1

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