A Comparative Study of Allogeneic and Autologous Bone Marrow Transplantation for Non-Hodgkin Lymphoma Patients

In recent years, bone marrow transplantation (BMT) has emerged as a promising treatment option for non-Hodgkin lymphoma (NHL) patients. Two primary modalities of BMT have been explored: allogeneic and autologous transplantation. While both approaches aim to cure NHL patients, the choice between them remains a subject of debate among healthcare professionals. This article reviews a comprehensive study conducted on 429 NHL patients who underwent either an allogeneic or autologous BMT from January 1986 to August 1997.

The study compared the outcomes of these two transplant modalities with respect to overall survival, rate of relapse, and treatment-related mortality. To ensure a fair comparison, patients were matched for age ± 5 years, disease status at BMT, disease histology, and year of BMT. The results showed that survival did not differ significantly between the allogeneic and autologous groups (relative risk of death after allotransplant: 0.711; 95% CI: 0.309–1.637).

However, treatment-related mortality was found to be higher in the allogeneic BMT group compared to the autologous group (23% vs 6%, respectively; P = 0.001). In contrast, the three-year actuarial rate of relapse was significantly lower after allogeneic BMT compared to autologous BMT (6% vs 41%, respectively; P = 0.0006).

Despite these differences, the three-year actuarial survival rates did not differ significantly between the two groups (71% vs 62%, respectively; P = 0.5330). A total of 68% of patients received their transplant for aggressive NHL, while the remaining patients had indolent lymphoma.

The study's findings suggest that both allogeneic and autologous BMT can be effective treatment options for NHL patients. However, they also highlight the potential risks associated with allogeneic transplantation, including a higher incidence of treatment-related mortality. The results may help inform clinical decisions regarding the choice of transplant modality for individual patients.

In conclusion, this study provides valuable insights into the comparative outcomes of allogeneic and autologous BMT in NHL patients. Further research is needed to better understand the optimal use of these treatments in different patient populations and to identify ways to minimize treatment-related mortality while maintaining efficacy.

Allogeneic bmt