Table 5.
Studies of allogeneic stem cell transplantation with fludarabine-melphalan conditioning in patients with lymphoid malignancies.
| Author Publication year/type |
Diagnosis and disease status * |
Median age (range) |
MRD/MU D/ mismatch |
Preparative regimen † | GVHD prophylaxis |
Primary graft failure (n) |
GVHD incidence (acute, chronic)‡ |
NRM § | PFS/OS § |
|---|---|---|---|---|---|---|---|---|---|
| Branson, 2002/R(139) |
10 H-NHL, 1 L-NHL, 2 MCL, 12 HL, 1 CLL, 12 MM [38] |
NA | 38/0/0 | FLU 150 mg/m2+ MEL 140 mg/m2 + ALE 100 mg |
CSA +MTX | NA | None (III–IV), 5 pts |
100d: 8% 14mo: 20% |
14mo: 50% / 53% |
| Morris, 2004/R(163) |
37 H-NHL, 41 L-NHL, 10 MCL [37] |
48 (18–73) | 63/17/8 | FLU 150 mg/m2+ MEL 140 mg/m2 + ALE 100 mg |
CSA | 1 pt | 13 pts, 6 pts | Early: 14 pts |
3yr: NA / 55% |
| Delgado, 2006/P(140) |
41 CLL [0] | 54 (37–67) | 24/13/4 | FLU 150 mg/m2+ MEL 140 mg/m2 + ALE 100 mg |
CSA | None | 4 pts (III–IV), 13 pts |
100d: 5% 2yr: 26% |
2yr: 45% / 51% |
| Rodriguez, 2006/R(164) |
19 H-NHL, 16 L-NHL, 5 MCL [16] |
NA | NA | FLU 125 mg/m2+ MEL 140 mg/m2 |
NA | NA | 65%, 76% | 2yr: 28% | LFU: 40% / 53% |
| Thomson, 2009/P(165) |
48 DLBCL [34] | 46 (23–64) | 29/10/9 | FLU 150 mg/m2+ MEL 140 mg/m2 + ALE 100 mg |
CSA | None | 8 pts, 9 pts | 4yr: 32% | 4yr: 48% / 47% |
| Alvarez, 2006/P(166) |
27 NS, 3 MC, 2 LD [29] |
31 (16–53) | 37/2/1 | FLU 150 mg/m2+ MEL 140 mg/m2 |
CSA + MTX | 1 pt | 42%, 47% | 100d: 12.5% 1yr: 25% |
2yr: 32% / 48% |
| Peggs, 2007/R(167) |
57 NS, 5 MC, 5 LP [53] |
35 (19–56) | 67/0/0 | FLU 150 mg/m2+ MEL 140 mg/m2 ± ALE 100 mg |
CSA ± MTX | 2 pts | 12 pts, 20 pts | NA | NA |
| Anderlini, 2008/R(141) |
58 HD [48] | 32 (19–59) | 25/33/0 | FLU 125 mg/m2+ MEL 140 mg/m2 + ATG |
TCR + MTX | None | 28%, 73% | 100d: 7% 2yr: 15% |
2yr: 32% / 64% |
Legend:
Number in brackets show the number of patients who previously had autologous stem cell transplantation;
Cumulative doses shown;
Cumulative incidences of grade II–IV acute GVHD followed by limited & extensive chronic GVHD shown unless indicated. If incidence is not available, number of patients were shown;
Time points shown (d: day, mo: month, yr: year) prior to incidence.
If incidence not available, number of patients was shown; R indicates retrospective; P, prospective; H-NHL, high- or intermediate-grade non-Hodgkin lymphoma; L-NHL, low-grade non-Hodgkin lymphoma; MCL, mantle cell lymphoma; HL, Hodgkin lymphoma; CLL, chronic lymphocytic leukemia; MM, multiple myeloma; DLBCL, diffuse large B-cell lymphoma; NS, nodular sclerosing Hodgkin lymphoma; MC, mixed cellularity Hodgkin lymphoma; LD, lymphocyte depleted Hodgkin lymphoma; LP, lymphocyte predominant Hodgkin lymphoma; MRD, matched related donor; MUD, matched unrelated donor; FLU, fludarabine; MEL, melphalan; ALE, alemtuzumab; ATG, anti-thymocyte globulin; TCR, tacrolimus; CSA, cyclosporine A; MTX, methotrexate; GVHD, graft-versus-host disease; NRM, non-relapse mortality; PFS, progression-free survival; OS, overall survival; LFU, last follow-up; lim, limited chronic GVHD; ext, extensive chronic GVHD; pts, patients; NA, not available.