Intensive chemotherapy with hematopoietic stem-cell support for children with recurrent or refractory NHL

J. T. Sandlund, L. Bowman, Helen Heslop, R. Krance, H. Mahmoud, C. H. Pui, G. Hale, E. Benaim

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background: Children with refractory or recurrent NHL are generally thought to have a poor prognosis. Those with chemosensitive disease are usually considered for an intensification phase, with either autologous or allogeneic hematopoietic stem-cell transplantation (HSCT). Methods: From 1990 to 2001 we performed 24 HSCTs in 22 children with refractory (n = 8), recurrent (n = 13), or high-risk in first CR (n = 1) NHL. Among the HSCTs, 19 were autologous and five were allogeneic. Results: In two children, allogeneic HSCT was performed after failing autologous HSCT. The histologic subtypes comprised large cell, (n = 13), Burkitt's lymphoma (n = 5) and lymphoblastic (n = 4). Among the cases of primary relapse, 10 occurred during therapy and three occurred after completing initial therapy. Among the 22 children in this series, two died of transplant-related toxicity and nine died of progressive disease or relapse after transplant. Among the 11 children who are alive and disease-free, 10 had non-lymphoblastic histology and one had lymphoblastic disease; one relapsed after autologous HSCT, but was successfully salvaged with multi-agent chemotherapy and involved-field irradiation. Among the 22 initial transplanted cases, 10 of 19 children with chemosensitive disease before transplantation and one of three with chemoresistant disease are currently alive and disease-free. Discussion: Intensive chemotherapy followed by hematopoietic stem-cell support is an effective strategy for children with chemosensitive recurrent non-lymphoblastic NHL.

Original languageEnglish (US)
Pages (from-to)253-258
Number of pages6
JournalCytotherapy
Volume4
Issue number3
DOIs
StatePublished - Jan 1 2002

Keywords

  • Children
  • Hematopoietic stem-cell transplantation
  • NHL

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Pharmacology

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