T-cell-depleted allogeneic transplant without donor leukocyte infusions results in excellent long-term survival in patients with multiply relapsed Lymphoma. Predictors for survival after transplant relapse

Leuk Lymphoma. 2011 Feb;52(2):214-22. doi: 10.3109/10428194.2010.538777. Epub 2010 Dec 10.


We analyzed 67 patients with lymphoma who received alemtuzumab-based conditioning regimens for allogeneic stem cell transplant and no post-transplant DLI. The median age was 54 (24-70), 43% had unrelated donors, 34% had chemotherapy refractory disease, and 25% had an elevated LDH. With a median follow-up for survivors of 35 months, the estimated 3-year progression-free survival (PFS) and overall survival (OS) were 30% and 47%, respectively. Chemosensitivity by CT and pre-transplant LDH were independent prognostic factors for both overall survival and progression-free survival. Patient age, performance status, donor type, lymphoma subtype, disease sensitivity by PET, and conditioning regimen did not correlate with PFS and OS. Patients who relapsed greater than 6 months after allogeneic transplant were frequently able to re-enter a subsequent durable remission. Our experience confirms the curative potential of alemtuzumab-containing RIC regimens for allogeneic HCT in patients with relapsed lymphoma without prophylactic DLI. An elevated pre-transplant LDH and chemorefractory disease prior to transplant confer a worse prognosis, while PET scan findings do not have this same implication. Patients who relapse greater than 6 months after their transplant are likely to achieve a subsequent remission with any of a variety of interventions, suggesting that GVL effects can be operative even after recurrence. Our outcomes challenge the utility of the common practice of prophylactic DLI after T-depleted transplant for lymphoma.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Graft vs Tumor Effect / immunology*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • L-Lactate Dehydrogenase / metabolism
  • Leukocyte Transfusion*
  • Lymphocyte Depletion*
  • Lymphoma / immunology
  • Lymphoma / mortality*
  • Lymphoma / therapy
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / immunology
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / therapy
  • Prognosis
  • Survival Rate
  • Tissue Donors
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Young Adult


  • Antineoplastic Agents
  • L-Lactate Dehydrogenase