We examined the role of hematopoietic stem cell transplantation (HSCT) for patients aged ≤ 18 years with refractory or recurrent Burkitt (n = 41), lymphoblastic (n = 53), diffuse large B cell (DLBCL; n = 52), and anaplastic large cell lymphoma (n = 36), receiving autologous (n = 90) or allogeneic (n = 92; 43 matched sibling and 49 unrelated donor) HSCT in 1990-2005. Risk factors affecting event-free survival (EFS) were evaluated using stratified Cox regression. Characteristics of allogeneic and autologous HSCT recipients were similar. Allogeneic donor HSCT was more likely to use irradiation-containing conditioning regimens, bone marrow (BM) stem cells, be performed in more recent years, and for lymphoblastic lymphoma. EFS rates were lower for patients not in complete remission at HSCT, regardless of donor type. After adjusting for disease status, 5-year EFS were similar after allogeneic and autologous HSCT for DLBCL (50% vs 52%), Burkitt (31% vs 27%), and anaplastic large cell lymphoma (46% vs 35%). However, EFS was higher for lymphoblastic lymphoma, after allogeneic HSCT (40% vs 4%; P < .01). Predictors of EFS for progressive or recurrent disease after HSCT included disease status at HSCT and use of allogeneic donor for lymphoblastic lymphoma. These data were unable to demonstrate a difference in outcome by donor type for the other histological subtypes.
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Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases (NIAID); Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI; Contract HHSH234200637015C with the Health Resources and Services Administration (HRSA/DHHS); Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research; and grants from AABB; Aetna; American Society for Blood and Marrow Transplantation; Amgen, Inc; anonymous donation to the Medical College of Wisconsin; Astellas Pharma US, Inc; Baxter International, Inc; Bayer HealthCare Pharmaceuticals; Be the Match Foundation; Biogen IDEC; BioMarin Pharmaceutical, Inc; Biovitrum AB; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Canadian Blood and Marrow Transplant Group; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Centers for Disease Control and Prevention; Children's Leukemia Research Association; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Cubist Pharmaceuticals; Cylex Inc; CytoTherm; DOR BioPharma, Inc; Dynal Biotech, an Invitrogen Company; Eisai, Inc; Enzon Pharmaceuticals, Inc; European Group for Blood and Marrow Transplantation; Gamida Cell, Ltd; GE Healthcare; Genentech, Inc; Genzyme Corporation; Histogenetics, Inc; HKS Medical Information Systems; Hospira, Inc; Infectious Diseases Society of America; Kiadis Pharma; Kirin Brewery Co, Ltd; The Leukemia & Lymphoma Society; Merck & Company; The Medical College of Wisconsin; MGI Pharma, Inc; Michigan Community Blood Centers; Millennium Pharmaceuticals, Inc; Miller Pharmacal Group; Milliman USA, Inc; Miltenyi Biotec, Inc; National Marrow Donor Program; Nature Publishing Group; New York Blood Center; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc; Otsuka America Pharmaceutical, Inc; Pall Life Sciences; Pfizer Inc; Saladax Biomedical, Inc; Schering Corporation; Society for Healthcare Epidemiology of America; StemCyte, Inc; StemSoft Software, Inc; Sysmex America, Inc; Teva Pharmaceutical Industries; THERAKOS, Inc; Thermogenesis Corporation; Vidacare Corporation; Vion Pharmaceuticals, Inc; ViraCor Laboratories; ViroPharma, Inc; and Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, or any other agency of the US Government.
- Allogeneic hematopoietic stem cell transplantation
- Autologous hematopoietic stem cell transplantation
- Non-Hodgkin lymphoma