Myeloablative Allo Sct As First Transplant Aggressive

Several single-arm cohort studies have used myeloabla-tive allo SCT for relapsed or, rarely, high-risk (for relapse) aggressive as well as low-grade NHL patients. Significantly fewer aggressive NHL patients have undergone this approach, as historically most patients have been offered auto SCT as therapy. Table 65.4 shows five series of myeloablative allo SCT for NHL.17-21 Most patients exhibited refractory disease at time of transplant, and as a result of extensive prior therapy and anticipated complications such as GvHD, nonrelapse mortality was quite high, accounting for death in one third to one half of patients. One single-institution series reported by Stein and colleagues20 noted only a 15% overall survival at 5 years after transplant, a reflection of advanced, heavily pretreated patients.

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