Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Mini Review
  • Published:

Mini-Review

Tandem transplantation in lymphoma

Abstract

The majority of poor-risk lymphoma patients are not cured with conventional chemotherapy. There is evidence for the superiority of single high-dose chemotherapy in such patients, but many still die from recurrent disease. Strategies to improve survival in these poor-risk patients include dose-intensification with high-dose chemotherapy and PBPC support, tandem autologous HDC with PBPC support, and autologous followed by non-myeloablative allogeneic transplantation. These more aggressive strategies are feasible and tolerable. Whether tandem transplantation will prove more effective than current single high-dose therapy in appropriately selected patients remains to be determined. Bone Marrow Transplantation (2001) 28, 529–535.

This is a preview of subscription content, access via your institution

Access options

Buy this article

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Linch D, Winfield D, Goldstone A et al. Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: results of a BNLI randomised trial Lancet 1993 341: 1051–1054

    Article  CAS  Google Scholar 

  2. Haioun C, Lepage E, Gisselbrecht C et al. Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin's lymphoma: final analysis of the prospective LNH87–2 protocol – a groupe d'Etude des Lymphomes de l'Adulte study J Clin Oncol 2000 18: 3025–3030

    Article  CAS  Google Scholar 

  3. Philip T, Guglielmi C, Hagenbeek A et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma New Engl J Med 1995 333: 1540–1545

    Article  CAS  Google Scholar 

  4. Philip T, Gomez F, Guglielmi C et al. Long-term outcome of relapsed non-Hodgkin's lymphoma patients included in the PARMA trial: incidence of late relapses, long-term toxicity and impact of the international prognostic index at relapse Proc Am Soc Clin Oncol 1998 17: 16a (Abstr. 62)

    Google Scholar 

  5. Vose JM, Zhang MJ, Rowlings PA et al. Autologous transplantation for diffuse aggressive non-Hodgkin's lymphoma in patients never achieving remission: a report from the Autologous Blood and Marrow Transplant Registry J Clin Oncol 2001 19: 406–413

    Article  CAS  Google Scholar 

  6. Lazarus HM, Rowlings PA, Zhang MJ et al. Autotransplants for Hodgkin's disease in patients never achieving remission: a report from the Autologous Blood and Marrow Transplant Registry J Clin Oncol 1999 17: 534–545

    Article  CAS  Google Scholar 

  7. Sweetenham JW, Carella AM, Taghipour G et al. High-dose therapy and autologous stem-cell transplantation for adult patients with Hodgkin's disease who do not enter remission after induction chemotherapy: results in 175 patients reported to the European Group for Blood and Marrow Transplantation. Lymphoma Working Party J Clin Oncol 1999 17: 3101–3109

    Article  CAS  Google Scholar 

  8. Sweetenham JW, Santini G, Qian W et al. High-dose therapy and autologous stem-cell transplantation vs conventional-dose consolidation/maintenance therapy as postremission therapy for adult patients with lymphoblastic lymphoma: results of a randomized trial of the European group for Blood and Marrow Transplantation and the United Kingdom Lymphoma Group J Clin Oncol 2001 19: 2927–2936

    Article  CAS  Google Scholar 

  9. Dansey R, Abella E, Karanes C et al. Updated analysis of patients with non-Hodgkin's lymphoma receiving either allogeneic or autologous transplants over a 12 year period Biol Blood Marrow Transplant 2001 7: 112 (Abstr. 149)

    Google Scholar 

  10. Goldstein S, Perkins F, Janssen W et al. A prospective, comparative trial of allogeneic vs autologous stem cell transplantation for high risk lymphoma: interim analysis Biol Blood Marrow Transplant 2001 7: 112 (Abstr. 150)

    Google Scholar 

  11. Blay J, Gomez F, Sebban C et al. The International Prognostic Index correlates to survival in patients with aggressive lymphoma in relapse: analysis of the PARMA trial. Parma Group Blood 1998 92: 3562–3568

    CAS  Google Scholar 

  12. Lynch J, Bierman P, Bociek G et al. The Hodgkin's disease prognostic index predicts outcome of autologous stem cell transplantation Proc Am Soc Clin Oncol 2001 20: 5a (Abstr. 17)

    Google Scholar 

  13. Alizadeh AA, Eisen MB, Davis RE et al. Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling Nature 2000 403: 503–511

    Article  CAS  Google Scholar 

  14. de Lima M, van Besien KW, Giralt SA et al. Bone marrow transplantation after failure of autologous transplant for non-Hodgkin's lymphoma Bone Marrow Transplant 1997 19: 121–127

    Article  CAS  Google Scholar 

  15. Vandenberghe E, Pearce R, Taghipour G, Goldstone A . Two autotransplants for lymphoma – acceptable toxicity (18%) of the second transplant and significant survival length in some patients. Data from the EBMT lymphoma registry Blood 1995 86: 971 (Abstr. 3871)

    Google Scholar 

  16. The International Non-Hodgkin's Lymphoma Prognostic Factors Project . A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project New Engl J Med 1993 329: 987–994

    Article  Google Scholar 

  17. Vitolo U, Bertini M, Brusamolino E et al. MACOP-B treatment in diffuse large-cell lymphoma: identification of prognostic groups in an Italian multicenter study J Clin Oncol 1992 10: 219–227

    Article  CAS  Google Scholar 

  18. Stoppa AM, Bouabdallah R, Chabannon C et al. Intensive sequential chemotherapy with repeated blood stem-cell support for untreated poor-prognosis non-Hodgkin's lymphoma J Clin Oncol 1997 15: 1722–1729

    Article  CAS  Google Scholar 

  19. Bouabdallah R, Stoppa AM, Rossi JF et al. Intensive sequential chemotherapy (ISC 95) with growth factors and blood stem cell support in high-intermediate and high-risk (IPI 2 and IPI 3) aggressive non-Hodgkin's lymphoma: an oligocentric report on 42 patients Leukemia 1999 13: 950–956

    Article  CAS  Google Scholar 

  20. Santini G, Coser P, Congiu AM et al. VACOP-B, high-dose cyclophosphamide and high-dose therapy with peripheral blood progenitor cell rescue for aggressive non-Hodgkin's lymphoma with bone marrow involvement: a study by the non-Hodgkin's Lymphoma Co-operative Study Group Haematologica 2000 85: 160–166

    CAS  PubMed  Google Scholar 

  21. Vitolo U, Cortellazzo S, Liberati AM et al. Intensified and high-dose chemotherapy with granulocyte colony-stimulating factor and autologous stem-cell transplantation support as first-line therapy in high-risk diffuse large-cell lymphoma J Clin Oncol 1997 15: 491–498

    Article  CAS  Google Scholar 

  22. Gianni AM, Bregni M, Siena S et al. High-dose chemotherapy and autologous bone marrow transplantation compared with MACOP-B in aggressive B-cell lymphoma New Engl J Med 1997 336: 1290–1297

    Article  CAS  Google Scholar 

  23. Bouabdallah R, Stoppa AM, Coso D et al. Clinical outcome after front-line intensive sequential chemotherapy (ISC) in patients with aggressive non-Hodgkin's lymphoma and high-risk international prognostic index (IPI 3): final analysis of survival in two consecutive ISC trials Ann Oncol 2001 12: 513–517

    Article  CAS  Google Scholar 

  24. Reyes F, Lepage E, Morel P et al. Failure of first-line induction high-dose chemotherapy in poor-risk patients with aggressive lymphoma: updated results of the randomized LNH93–3 study Blood 1997 90: (Suppl. 1) 594a (Abstr. 2640)

    Google Scholar 

  25. Schenkein DP, Roitman D, Miller KB et al. A phase II multicenter trial of high-dose sequential chemotherapy and peripheral blood stem cell transplantation as initial therapy for patients with high-risk non-Hodgkin's lymphoma Biol Blood Marrow Transplant 1997 3: 210–216

    CAS  PubMed  Google Scholar 

  26. Johnston LJ, Stockerl-Goldstein KE, Hu WW et al. Toxicity of high-dose sequential chemotherapy and purged autologous hematopoietic cell transplantation precludes its use in refractory/recurrent non-Hodgkin's lymphoma Biol Blood Marrow Transplant 2000 6: 555–562

    Article  CAS  Google Scholar 

  27. Stewart DA, Guo D, Gluck S et al. Double high-dose therapy for Hodgkin's disease with dose-intensive cyclophosphamide, etoposide, and cisplatin (DICEP) prior to high-dose melphalan and autologous stem cell transplantation Bone Marrow Transplant 2000 26: 383–388

    Article  CAS  Google Scholar 

  28. Fitoussi O, Simon D, Brice P et al. Tandem transplant of peripheral blood stem cells for patients with poor-prognosis Hodgkins's disease or non-Hodgkin's lymphoma Bone Marrow Transplant 1999 24: 747–755

    Article  CAS  Google Scholar 

  29. Philip T, Bouabdallah R, Brice P et al. Phase II study testing a double intensification in aggressive non-Hodgkin's lymphoma relapsing less than one year after initial treatment (PARMA2 study) Bone Marrow Transplant 2000 25: (Suppl. 1) S180 (Abstr. P559)

    Google Scholar 

  30. Ballestrero A, Clavio M, Ferrando F et al. High-dose chemotherapy with tandem autologous transplantation as part of the initial therapy for aggressive non-Hodgkin's lymphoma Int J Oncol 2000 17: 1007–1013

    CAS  PubMed  Google Scholar 

  31. Hesdorffer C, Garvin J, Vahdat L et al. A novel regimen of tandem high dose therapy and autologous stem cell transplantation for poor risk lymphoma Proc Am Soc Clin Oncol 1999 18: 46a (Abstr. 170)

    Google Scholar 

  32. Brice P, Divine M, Simon D et al. Feasibility of tandem autologous stem-cell transplantation (ASCT) in induction failure or very unfavorable (UF) relapse from Hodgkin's disease (HD). SFGM/GELA Study Group Ann Oncol 1999 10: 1485–1488

    Article  CAS  Google Scholar 

  33. van Besien KW, de Lima M, Giralt SA et al. Management of lymphoma recurrence after allogeneic transplantation: the relevance of graft-versus-lymphoma effect Bone Marrow Transplant 1997 19: 977–982

    Article  CAS  Google Scholar 

  34. Khouri IF, Lee MS, Romaguera J et al. Allogeneic hematopoietic transplantation for mantle-cell lymphoma: molecular remissions and evidence of graft-versus-malignancy Ann Oncol 1999 10: 1293–1299

    Article  CAS  Google Scholar 

  35. Carella AM, Champlin R, Slavin S et al. Mini-allografts: ongoing trials in humans Bone Marrow Transplant 2000 25: 345–350

    Article  CAS  Google Scholar 

  36. Khouri IF, Keating M, Korbling M et al. Transplant-lite: induction of graft-versus-malignancy using fludarabine-based nonablative chemotherapy and allogeneic blood progenitor-cell transplantation as treatment for lymphoid malignancies J Clin Oncol 1998 16: 2817–2824

    Article  CAS  Google Scholar 

  37. Kottaridis P, Milligan D, Mahendra P et al. Non-myeloablative conditioning limits transplant related mortality in patients who have previously failed high dose treatment Blood 2000 96: 553a (Abstr. 2375)

    Google Scholar 

  38. Kottaridis P, Milligan D, Chopra R et al. A non-myeloablative regimen with minimal non relapse mortality for allografting patients with Hodgkin's disease Bone Marrow Transplant 2001 27: S66 (Abstr. OS285)

    Google Scholar 

  39. Nagler A, Slavin S, Varadi G et al. Allogeneic peripheral blood stem cell transplantation using a fludarabine-based low intensity conditioning regimen for malignant lymphoma Bone Marrow Transplant 2000 25: 1021–1028

    Article  CAS  Google Scholar 

  40. Anderlini P, Giralt S, Andersson B et al. Allogeneic stem cell transplantation with fludarabine-based, less intensive conditioning regimens as adoptive immunotherapy in advanced Hodgkin's disease Bone Marrow Transplant 2000 26: 615–620

    Article  CAS  Google Scholar 

  41. Robinson S, Mackinnon S, Goldstone A et al. Higher than expected transplant-related mortality and relapse following non-myeloablative stem cell transplantation for lymphoma adversely effects progression-free survival Blood 2000 96: 554a (Abstr. 2380)

    Google Scholar 

  42. Carella AM, Cavaliere M, Lerma E et al. Autograftingfollowed by nonmyeloablative immunosuppressivechemotherapy and allogeneic peripheral-blood hematopoieticstem-cell transplantation as treatment of resistant Hodgkin's disease and non-Hodgkin's lymphoma J Clin Oncol 2000 18: 3918–3924

    Article  CAS  Google Scholar 

  43. Spielberger R, Stiff P, Emmanouilides C et al. Efficacy of recombinant human keratinocyte growth factor (rHuKGF) in reducing mucositis in patients with hematologic malignancies undergoing autologous peripheral blood progenitor cell transplantation after radiation-based conditioning – results of a phase 2 trial Proc Am Soc Clin Oncol 2001 20: 7a (Abstr. 25)

    Google Scholar 

  44. Durrant S, Pico J, Schmitz N et al. A phase 1 study of recombinant human keratinocyte growth factor (rHuKGF) in lymphoma patients receiving high-dose chemotherapy with autologous peripheral blood progenitor cell transplantation Blood 1999 94: 708a (Abstr. 3130)

    Google Scholar 

  45. Flinn IW, Lazarus HM . Monoclonal antibodies and autologous stem cell transplantation for lymphoma Bone Marrow Transplant 2001 27: 565–569

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported in part by the Julie Gould Fund (KPP).

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Papadopoulos, K., Noguera-Irizarry, W. & Hesdorffer, C. Tandem transplantation in lymphoma. Bone Marrow Transplant 28, 529–535 (2001). https://doi.org/10.1038/sj.bmt.1703201

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703201

Keywords

This article is cited by

Search

Quick links