According to results of a study published in the International Journal of Hematology, a reduced-intensity conditioning regimen prior to allogenic hematopoietic stem cell transplantation (HSCT) for relapsed or refractory anaplastic large cell lymphoma (ALCL) may improve survival outcomes in children, adolescents, and young adults compared with a myeloablative conditioning regimen.

Researchers conducted a retrospective analysis of data from patients who had been diagnosed with relapsed or refractory ALCL and underwent allogeneic HSCT between January 1990 and December 2010. The data were collected from the transplant registries of the Japan Society for Hematopoietic Cell Transplantation. The outcomes of interest were overall survival (OS) and event-free survival (EFS).

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Data from 38 patients were assessed; median follow-up after allogeneic HSCT was 72 months (range, 35-96). Two conditioning regimens were compared: reduced-intensity conditioning (8 patients; median age at transplant, 23.5 years; range, 9-29) and myeloablative conditioning (30 patients; median age at transplant, 15 years; range, 3-30).

The 5-year OS was 100% and 48.5% for the reduced-intensity and myeloablative conditioning groups, respectively (P =.018). The 5-year EFS was 87.5% and 42.8% for the reduced-intensity and myeloablative conditioning groups, respectively (P =.039). Of the 8 patients who received the reduced-intensity conditioning regimen, 4 had residual disease at allogeneic HSCT; however, all 8 patients survived and ultimately achieved complete remission.

The researchers noted the limitations of this retrospective analysis, highlighting that physicians may have preferred to give the reduced-intensity regimen to patients who had a lower risk for relapse. However, in this study, the only significantly different patient characteristic between the 2 groups was age (P =.041).

The researchers concluded, “To clarify the efficacy of the reduced-intensity conditioning regimen for relapsed or refractory ALCL, a prospective trial of allogeneic HSCT using the reduced-intensity conditioning regimen is needed.”

Reference

1.      Fukano R, Mori T, Fujita N, et al. Successful outcome with reduced-intensity condition regimen followed by allogeneic hematopoietic stem cell transplantation for relapsed or refractory anaplastic large-cell lymphoma. Int J Hematol. 2019;110:723-728.