Reducedconditioning Allo Sct As First Transplant Follicular

Data from five small studies using reduced-intensity conditioning and allo SCT as first transplant for follicular NHL are shown in Table 65.9.47-50 In several reports, a variety of hematologic malignancy patients were treated in this fashion, and the data for follicular NHL have been culled out. The median follow-up for these series is short, but treatment-related mortality remains relatively low at approximately 20% at 1 year, except in the report by Robinson and colleagues.50 In that study, the authors note inexplicably high treatment-related mortality and relapse rates. More patients need to be accrued to therapy and a longer duration of follow-up must be reported before stating that reduced-intensity allo SCT changes the natural history of follicular NHL; however, the high PFS rate of approximately 70% is encouraging. The monoclonal antibody Campath-1, now being used with increased frequency, may contribute to improved patient outcome.51 Chakraverty et al.51 incorporated Campath-1 into the conditioning regimen for 47 matched-unrelated donor allo SCT, 29 of whom failed auto SCT. Eighty-five percent of patients attained full donor chimerism and day 100 nonrelapse mortality was 14.9%. One-year progression-free and overall survivals were 61.5 and 75.5%, respectively.

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