Annals of Oncology 13:1507, 2002
© 2002 European Society for Medical Oncology
Letters to the Editor |
Allogeneic stem cell transplantation for patients with resistant high-grade lymphoma: what is the potential of reduced-intensity conditioning?
AK St Georg, Dept. Hematology, Lohmühlenstrasse 5, 20099 Hamburg, Germany (E-mail: peter.dreger@ak-stgeorg.lbk-hh.de)
In the January 2002 issue of Annals of Oncology, Bertz et al. showed nicely that allogeneic stem cell transplantation (SCT) using reduced-intensity conditioning (RIC) is an effective treatment for resistant low/intermediate-grade lymphoma [1]. They further concluded that allogeneic SCT might be a promising treatment option for non-Hodgkin’s lymphoma in general, and that RIC can be expected to be superior to conventional conditioning (CC) for that purpose. These two latter statements, however, appear to be a little too optimistic with regard to the data presented: apart from the Hodgkin’s patients, the RIC and CC cohorts are also heavily imbalanced for the distribution of the non-Hodgkin’s lymphoma subtypes. High-grade lymphomas account for 67% of the CC cases, but only 25% of the RIC cases, whereas low-grade/intermediate lymphomas comprise 63% of the RIC versus 0% of the CC cohorts. The fatality rate of the high-grade lymphomas is reported to be 75% after CC and 67% after RIC. Thus, it remains to be shown whether allogeneic SCT can improve the prognosis of resistant high-grade lymphoma, and whether this can be achieved by RIC regimens [2, 3]. In fact, the only two long-term survivors of high-grade lymphoma in the present series had received CC.
P. Dreger
AK St Georg, Department Hematology, Lohmühlenstrasse 5, 20099 Hamburg, Germany (E-mail: peter.dreger{at}ak-stgeorg.lbk-hh.de)
References
1. Bertz H, Illerhaus G, Veelken H, Finke J. Allogeneic hematopoietic stem-cell transplantation for patients with relapsed or refractory lymphomas: comparison of high-dose conventional conditioning versus fludarabine-based reduced-intensity regimens. Ann Oncol 2002; 13: 135–139.
2. Corradini P, Tarella C, Olivieri A et al. Reduced-intensity conditioning followed by allografting of hematopoietic cells can produce clinical and molecular remissions in patients with poor-risk hematologic malignancies. Blood 2002; 99: 75–82.
3. Chakraverty R, Peggs K, Chopra R et al. Limiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen. Blood 2002; 99: 1071–1107.
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