Conflict of interest: Nothing to declare.
Ten-year follow-up of pediatric patients with non-hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation
Article first published online: 30 AUG 2013
© 2013 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 60, Issue 12, pages 2018–2024, December 2013
How to Cite
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. and Boulad, F. (2013), Ten-year follow-up of pediatric patients with non-hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation. Pediatr. Blood Cancer, 60: 2018–2024. doi: 10.1002/pbc.24722
Lisa Giulino-Roth and Rosanna Ricafort contributed equally to this work.
- Issue published online: 8 OCT 2013
- Article first published online: 30 AUG 2013
- Manuscript Accepted: 12 JUL 2013
- Manuscript Received: 14 MAR 2013
- allogeneic stem cell transplant;
- autologous stem cell transplant;
- non-Hodgkin lymphoma;
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.
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).
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).
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. © 2013 Wiley Periodicals, Inc.