Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience
Introduction: Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a curative option for relapse/refractory (R/R) lymphomas that have failed autologous transplantation or for high-risk lymphomas in the upfront setting. We conducted a retrospective analysis on consecutive lymphoma pati...
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Academy of Medicine Singapore
2025-01-01
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| Series: | Annals, Academy of Medicine, Singapore |
| Online Access: | https://annals.edu.sg/long-term-survival-and-clinical-implications-of-allogeneic-stem-cell-transplantation-in-relapse-refractory-lymphoma-a-20-year-singapore-experience |
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| author | Wei Sheng Joshua Loke Jean Rachel Catapia Chay Lee Low Francesca Lim Jeffrey Quek Hein Than Yeow Tee Goh Yeh Ching Linn Colin Phipps Diong Aloysius Ho William Hwang Chung Cheng Jordan Hwang Aditi Ghosh Liang Pui Koh Lip Koon Tan Joanne Lee Li Mei Michelle Poon Cheng Kiat Lawrence Ng |
| author_facet | Wei Sheng Joshua Loke Jean Rachel Catapia Chay Lee Low Francesca Lim Jeffrey Quek Hein Than Yeow Tee Goh Yeh Ching Linn Colin Phipps Diong Aloysius Ho William Hwang Chung Cheng Jordan Hwang Aditi Ghosh Liang Pui Koh Lip Koon Tan Joanne Lee Li Mei Michelle Poon Cheng Kiat Lawrence Ng |
| author_sort | Wei Sheng Joshua Loke |
| collection | DOAJ |
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Introduction: Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a curative option for relapse/refractory (R/R) lymphomas that have failed autologous transplantation or for high-risk lymphomas in the upfront setting. We conducted a retrospective analysis on consecutive lymphoma patients who underwent allo-HSCT over a 20-year period (2003– 2022) at Singapore General Hospital and National University Hospital Singapore. Method: A total of 121 patients were included in the study. Median age was 41 years. Diagnoses include Hodgkin lymphoma (HL, 15%), B-cell non- Hodgkin lymphoma (B-NHL, 34%), T-cell non-Hodgkin lymphoma (T-NHL, 31%) and natural killer T-cell lymphoma (NKTL, 20%). Moreover, 27% of patients had prior auto-haematopoietic stem cell transplanta-tion (auto-HSCT), and 84% received reduced intensity conditioning (RIC). Donor types were matched sibling donor (45%), matched unrelated donor (29%), haploidentical donor (19%) and cord blood (CB, 7%). Results: After median follow-up of 56 months, estimated 4-year progression-free survival (PFS) and overall survival (OS) for all patients were 38% and 45%, respectively. Non-relapse mortality (NRM) was 15% at day 100 and 24% at 1 year. On univariate analysis, complete remission status at transplant and RIC confers superior OS. On multivariate analysis, HL was associated with superior OS compared to NHL, whereas matched unrelated donor transplant was associated with significantly inferior OS compared to matched sibling donor. Conclusion: Long-term curative durability was observed with allo-HSCT for patients with relapsed/ refractory lymphomas. This real-world data serves as a valuable historical benchmark for future studies on lymphomas in Singapore and the Asia Pacific region. |
| format | Article |
| id | doaj-art-0512c8ed867f434abad0a1560a557614 |
| institution | Kabale University |
| issn | 2972-4066 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Academy of Medicine Singapore |
| record_format | Article |
| series | Annals, Academy of Medicine, Singapore |
| spelling | doaj-art-0512c8ed867f434abad0a1560a5576142025-02-03T10:40:22ZengAcademy of Medicine SingaporeAnnals, Academy of Medicine, Singapore2972-40662025-01-0154151610.47102/annals-acadmedsg.2024178Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experienceWei Sheng Joshua LokeJean Rachel CatapiaChay Lee LowFrancesca LimJeffrey QuekHein ThanYeow Tee GohYeh Ching LinnColin Phipps DiongAloysius HoWilliam HwangChung Cheng Jordan HwangAditi GhoshLiang Pui KohLip Koon TanJoanne LeeLi Mei Michelle PoonCheng Kiat Lawrence Ng Introduction: Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a curative option for relapse/refractory (R/R) lymphomas that have failed autologous transplantation or for high-risk lymphomas in the upfront setting. We conducted a retrospective analysis on consecutive lymphoma patients who underwent allo-HSCT over a 20-year period (2003– 2022) at Singapore General Hospital and National University Hospital Singapore. Method: A total of 121 patients were included in the study. Median age was 41 years. Diagnoses include Hodgkin lymphoma (HL, 15%), B-cell non- Hodgkin lymphoma (B-NHL, 34%), T-cell non-Hodgkin lymphoma (T-NHL, 31%) and natural killer T-cell lymphoma (NKTL, 20%). Moreover, 27% of patients had prior auto-haematopoietic stem cell transplanta-tion (auto-HSCT), and 84% received reduced intensity conditioning (RIC). Donor types were matched sibling donor (45%), matched unrelated donor (29%), haploidentical donor (19%) and cord blood (CB, 7%). Results: After median follow-up of 56 months, estimated 4-year progression-free survival (PFS) and overall survival (OS) for all patients were 38% and 45%, respectively. Non-relapse mortality (NRM) was 15% at day 100 and 24% at 1 year. On univariate analysis, complete remission status at transplant and RIC confers superior OS. On multivariate analysis, HL was associated with superior OS compared to NHL, whereas matched unrelated donor transplant was associated with significantly inferior OS compared to matched sibling donor. Conclusion: Long-term curative durability was observed with allo-HSCT for patients with relapsed/ refractory lymphomas. This real-world data serves as a valuable historical benchmark for future studies on lymphomas in Singapore and the Asia Pacific region.https://annals.edu.sg/long-term-survival-and-clinical-implications-of-allogeneic-stem-cell-transplantation-in-relapse-refractory-lymphoma-a-20-year-singapore-experience |
| spellingShingle | Wei Sheng Joshua Loke Jean Rachel Catapia Chay Lee Low Francesca Lim Jeffrey Quek Hein Than Yeow Tee Goh Yeh Ching Linn Colin Phipps Diong Aloysius Ho William Hwang Chung Cheng Jordan Hwang Aditi Ghosh Liang Pui Koh Lip Koon Tan Joanne Lee Li Mei Michelle Poon Cheng Kiat Lawrence Ng Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience Annals, Academy of Medicine, Singapore |
| title | Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience |
| title_full | Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience |
| title_fullStr | Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience |
| title_full_unstemmed | Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience |
| title_short | Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience |
| title_sort | long term survival and clinical implications of allogeneic stem cell transplantation in relapse refractory lymphoma a 20 year singapore experience |
| url | https://annals.edu.sg/long-term-survival-and-clinical-implications-of-allogeneic-stem-cell-transplantation-in-relapse-refractory-lymphoma-a-20-year-singapore-experience |
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