TRANSPLANTATION Myeloablative allogeneic hematopoietic stem cell transplantation for non-Hodgkin lymphoma: a nationwide survey in Japan

We retrospectively surveyed the data of 233 patients who underwent myeloabla-tive allogeneic hematopoietic stem cell transplantation (allo-HSCT) for non-Hodgkin lymphoma (NHL). Donors were HLA-matched relatives in 154 patients (66%) or unrelated volunteers in 60 (26%). Ninety patients (39%) were in complete remission. One hundred ninety-three (83%) received a total body irradiation (TBI)–based regimen, and 40 (17%) re-ceived a non–TBI-based regimen. Acute graft-versus-host disease (GVHD) oc-curred in 155 (67%) of the 233 evaluable patients; grade II to IV in 90 (39%), and grade III to IV in 37 (16%). Treatment-related mortality (TRM) was observed in 98 patients (42%), and 68 % of them were related to GVHD. In a multivariate analy-sis, chemoresistance, prior autograft, and chronic GVHD were identified as adverse prognostic factors for TRM. Relapse or progression of lymphoma was observed in 21%. The 2-year overall survival rates of the patients with indolent (n 38), aggressive (n 111), and lymphoblastic lymphoma (n 84) were 57%, 42%, and 41%, respectively. In a multivariate analy-sis, chemoresistance, prior autograft, and prior radiotherapy were identified as ad-verse prognostic factors for overall sur-vival. Although myeloablative allo-HSCT represents an effective therapeutic op-tion for patients with NHL, more work is still needed to decrease TRM and relapse