Journal of Clinical Oncology, Vol 10, 1690-1695, Copyright © 1992 by American Society of Clinical Oncology
Autologous versus allogeneic bone marrow transplantation for non- Hodgkin's lymphoma: a case-controlled analysis of the European Bone Marrow Transplant Group Registry data
R Chopra, AH Goldstone, R Pearce, T Philip, F Petersen, F Appelbaum, E De Vol and P Ernst
Department of Hematology, University College and Middlesex School of Medicine, London, United Kingdom.
PURPOSE: A case-controlled study of patients who reported to the European
Bone Marrow Transplant Group (EBMTG) was performed to investigate the
relative roles and efficacy of allogeneic (alloBMT) and autologous bone
marrow transplantation (ABMT) in non-Hodgkin's lymphoma. PATIENTS AND
METHODS: Of 1,060 patients who reported to the lymphoma registry, 938
patients underwent ABMT and 122 patients underwent alloBMT. A
case-controlled study was performed by matching 101 alloBMT patients with
101 ABMT patients. The case matching was performed after the selection of
the main prognostic factors for progression-free survival by a multivariate
analysis. RESULTS: The progression-free survival was similar in both types
of transplants (49% alloBMT v 46% ABMT). The overall relapse and
progression rate for the alloBMT patients was 23% compared with 38% in the
ABMT patients. This difference was not significant statistically. In the
lymphoblastic lymphoma subgroup, alloBMT was associated with a lower
relapse rate than ABMT (24% alloBMT v 48% ABMT; P = .035). The
progression-free survival, however, was not significantly different because
patients with lymphoblastic lymphoma who underwent alloBMT had a higher
procedure-related mortality (24% alloBMT v 10% ABMT; P = .06). A
significantly lower relapse/progression rate was also observed in patients
with chronic graft-versus-host disease (cGVHD) compared with those patients
without (0% cGVHD v 35% no cGVHD; P = .02). Fourteen of 18 patients who had
cGVHD also had lymphoblastic lymphoma. CONCLUSION: This study suggests that
ABMT and alloBMT for non-Hodgkin's lymphoma are comparable, with the
exception of lymphoblastic lymphoma in which a graft-versus-lymphoma effect
may account for the lower relapse rate for patients who underwent alloBMT.
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