Rowena D Faulkner*, Charles Craddock, Jennifer L Byrne, Prem Mahendra, Andrew P Haynes, Hugh G Prentice, Michael Potter, Antonio Pagliuca, Aloysius Ho, Stephen Devereux, Grant McQuaker, Ghulam Mufti, John Liu Yin, and Nigel H Russell

¹ Department of Haematology, City Hospital, Nottingham, United Kingdom
² Department of Haematology, University Hospital, Birmingham, United Kingdom
³ Department of Haematology, Royal Free Hospital, London, United Kingdom
⁴ Department of Haematology, Kings College Hospital, London, United Kingdom
⁵ Department of Haematology, Glasgow Royal Infirmary, Glasgow, United Kingdom
⁶ Department of Haematology, Manchester Royal Infirmary, Manchester, United Kingdom

* Corresponding author; email:  rowena.bainton@nottingham.ac.uk

We report the outcomes of reduced-intensity allogeneic stem cell transplantation using BEAM-Campath
conditioning (BCNU, etoposide, cytosine arabinoside, melphalan and Campath 10 mg/day on days -5 to -1) in
6 UK Transplant Centres. Sixty five patients with lymphoproliferative diseases underwent sibling (n=57) or
matched unrelated donor (n=8) transplantation. ( Low grade and transformed low grade non-Hodgkin's lymphoma: 28; Mantle cell lymphoma: 5; High grade non-Hodgkin's lymphoma: 8; Chronic lymphocytic leukemia/prolymphocytic leukemia: 13; Peripheral T-cell lymphoma: 6; and Hodgkin's lymphoma: 5).
Sustained donor engraftment occurred in 60/62 patients (97%). 35/56 patients (63%) undergoing chimerism studies had full donor chimerism. 73% were in CR (Complete response) post-transplantation. At a median follow-up of 1.4 years (range 0.1-5.6 years), 37 remain alive and in CR. Acute GVHD (Graft vs. host disease) occurred in 11/64 (17%), Grade I-II only. Estimated 1 year TRM (transplant-related mortality) was 8% for patients undergoing first transplantation but was significantly worse for those who had undergone previous autologous transplantation. Six patients relapsed (estimated 2 year relapse risk 20%). Histological diagnosis (MCL and high grade NHL) and age at transplantation (>46 years old) were significantly associated with higher relapse risk and worse EFS (event-free survival). Relapse did not occur in any patient who developed acute or chronic GVHD. This study demonstrates that reduced intensity allogeneic stem cell transplantation for lymphoproliferative diseases using a BEAM-Campath preparative regimen is associated with sustained donor engraftment, a high response rate, minimal toxicity and a low incidence of GVHD.

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