Edward Agura

Non-myeloablative allogeneic haematopoietic cell transplantation for relapsed diffuse large B-cell lymphoma: a multicentre experience.

Patients with relapsed diffuse large B‐cell lymphoma (DLBCL) who have failed or are ineligible for autologous haematopoietic cell transplantation (HCT) have a poor prognosis. We examined the outcomes of non‐myeloablative allogeneic HCT in this setting. Thirty‐one patients with DLBCL and one patient with Burkitt lymphoma received allogeneic HCT following 2 Gy total body irradiation with or without fludarabine. Median age was 52 years. Twenty‐four patients (75%) had undergone prior autologous HCT. Disease status at HCT was complete response (14/32, 44%), partial response (9/32, 28%), or refractory (9/32, 28%). Cumulative incidences of acute graft‐versus‐host disease (GVHD) grades II–IV, grades III–IV, and chronic GVHD were 53%, 19%, and 47% respectively. With a median follow‐up of 45 months, 3‐year estimated overall (OS) and progression‐free survival (PFS) was 45% and 35% respectively. Three‐year cumulative incidences of relapse and non‐relapse mortality were 41% and 25% respectively. In multivariate models, chemosensitive disease and receipt of ≥4 lines of treatment before HCT were associated with better OS. Patients with chemosensitive disease had 3‐year OS and PFS of 56% and 43% respectively. Non‐myeloablative allogeneic HCT can produce long‐term disease‐free survival in patients with chemosensitive relapsed DLBCL who have failed or are ineligible for autologous HCT.