- © 2000 by American Society of Clinical Oncology
Allogeneic Transplantation for Low-Grade Lymphoma: Long-Term Follow-Up
To the Editor:
In 1995 we reported on 10 patients with a history of advanced, refractory low-grade lymphoma who had undergone allogeneic transplantation.1 Seven patients had follicle-center lymphomas, two had small lymphocytic lymphomas, and one had a mantle cell lymphoma. Two patients had died from transplant-related toxicity and eight had obtained remissions. With a median follow-up of 27 months (range, 11 to 62 months), no recurrences had occurred. Figure 1 shows the survival and disease-free survival of this patient cohort as of October 1999. Currently, the median follow-up is 6 years after transplantation (range, 5 to 9 years), and only one patient has developed disease progression. That patient is currently in remission 8 years after the initial transplant and 4 years after a second allogeneic transplantation. That same patient developed extensive chronic graft-versus-host disease after transplantation and developed disease recurrence while receiving chronic immunosuppression. Two additional patients have developed limited chronic graft-versus-host disease, and one patient has developed aseptic hip necrosis. No other posttransplant complications have occurred.
Fig 1. Survival and disease-free survival.
Since our initial publication, several groups have confirmed the ability to induce remissions of low-grade lymphoma with allogeneic transplantation, but the median follow-up in these studies was, at best, 3 years.2-5 Hence, the possibility remained that, as with autologous transplantation, late recurrences and complications such as secondary MDS would affect long-term outcome.6 However, our data, admittedly obtained on a small patient sample, indicate the possibility of durable remissions in the majority of survivors of allogeneic transplantation. Confirmation of these data in larger studies with long follow-up is necessary.
