Ajay Prakash - Division of Oncology, Saskatchewan Cancer Agency, College of Medicine, University of Saskatchewan, Regina, Canada
Hugh Goodman - Department of Hematology, Waikato Hospital, Hamilton, New Zealand

Background: Autologous stem cell transplant (ASCT) has been used as a consolidative treatment modality in non-Hodgkin’s lymphoma (NHL), but its role in NHL management is still evolving. The study aimed to evaluate the patient outcomes based on age, NHL subtypes, and conditioning regimen.Method: We performed a retrospective analysis of NHL patients who received ASCT (n = ۱۴۰) in our centre from ۱۹۹۲-۲۰۱۵. Data were gathered for this investigation using electronic records and case notes. Refractory illness, relapse, progressive disease, or death were all considered progression events. Time from ASCT to the last follow-up or progression event was used to define progression-free survival (PFS), and time from ASCT to death or the final follow-up was used to define overall survival (OS).Results: Median age at ASCT was ۵۵ years (۱۶-۶۸). Amongst patients ≤۶۰ years (n = ۱۰۹) and >۶۰ years (n = ۳۱), there was no significant difference in PFS (P = ۰.۷۵۶), OS (P = ۰.۷۱۱), neutrophil (۱۲.۵ vs. ۱۱ days) and platelet (۱۲ vs. ۱۴ days) engraftment times. Amongst follicular lymphoma patients (n = ۵۴) who received BEAM (carmustine, etoposide, cytarabine, melphalan) (n = ۳۰) or Cy/TBI (cyclophosphamide/ total body irradiation) (n=۲۴) conditioning, there was no significant difference between PFS (P = ۰.۱۱۱) and OS (P = ۰.۶۶۷). There was no significant difference (P = ۰.۴۶) in the incidence of second malignancies in the patient receiving BEAM or TBI-based conditioning.Conclusion: ASCT can be safely performed for NHL in patients >۶۰ years with outcomes similar to those ≤۶۰ years. TBI based conditioning appear safe with similar outcomes to BEAM in follicular lymphoma patients. Prospective studies are needed to confirm these findings.

Non-Hodgkin lymphoma, Stem cell transplant, Autologous, Total body irradiation, Transplantation conditioning