Tandem autologous-allo-SCT is feasible in patients with high-risk relapsed non-Hodgkin's lymphoma

Allo-SCT is used to exploit GVL effect in high-risk relapsed non-Hodgkin's lymphoma (NHL). Here, we retrospectively analyzed 34 high-risk NHL patients who underwent auto-SCT followed closely by reduced-intensity allo-SCT ('tandem auto-allo') from January 2002 to November 2010. The search for an allogeneic donor was started at the beginning of salvage regimen. Median patients' age was 47 (27-68) years; histotypes were: diffuse large B-cell n = 5, follicular n = 14, transformed follicular n = 4, mantle-cell n = 5, plasmocytoid lymphoma n = 1, anaplastic large T-cell n = 2, peripheral T-cell n = 3. Donors were HLA-identical siblings (n = 29) or 10/10-matched unrelated individuals (n = 5). Median interval between auto-SCT and allo-SCT was 77 days (36-197). At a median follow-up of 46 (8-108) months since allo-SCT, 5-year OS is 77% (61-93) and PFS is 68% (51-85). Disease relapse or progression occurred in six patients, 100-day TRM was 0%, 2-year TRM incidence was 6%. In conclusion, tandem transplantation is feasible in high-risk NHL patients having a HLA-identical donor. This approach could represent a suitable therapeutic option for those patients with high-risk NHL potentially benefitting from further therapy after auto-SCT. Donor searches should be started promptly whenever such an approach is chosen. Bone Marrow Transplantation (2013) 48, 249-252; doi:10.1038/bmt.2012.116; published online 25 June 2012