Allogeneic Transplantation for Relapsed Waldenström Macroglobulinemia and Lymphoplasmacytic Lymphoma
Year: 2016
Type: article
Study design: Observational Study
Abstract: Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) is characterized by lymphoplasmacytic proliferation, lymph node and spleen enlargement, bone marrow involvement, and IgM production. Treatment varies based on the extent and biology of disease. In some patients, the use of allogeneic hematopoietic cell transplantation (alloHCT) may have curative potential. We evaluated long-term outcomes of 144 patients who received adult alloHCT for WM/LPL. Data were obtained from the Center for International Blood and Marrow Transplant Research database (2001 to 2013). Patients received myeloablative(n = 67) or reduced-intensity conditioning (RIC; n = 67). Median age at alloHCT was 53 years, and median time from diagnosis to transplantation was 41 months. Thirteen percent (n = 18) failed prior autologous HCT. About half (n = 82, 57%) had chemosensitive disease at the time of transplantation, whereas 22% had progressive disease. Rates of progression-free survival, overall survival, relapse, and nonrelapse mortality at 5 years were 46%, 52%, 24%, and 30%, respectively. Patients with chemosensitive disease and better pretransplant disease status experienced significantly superior overall survival. There were no significant differences in progression-free survival based on conditioning (myeloablative, 50%, versus RIC, 41%) or graft source. Conditioning intensity did not impact treatment-related mortality or relapse. The most common causes of death were primary disease and graft-versus-host disease (GVHD). AlloHCT yielded durable survival in select patients with WM/LPL. Strategies to reduce mortality from GVHD and post-transplant relapse are necessary to improve this approach.
Authors: Robert F. Cornell, Veronika Bachanova, Anita D'Souza, Kwang Woo-Ahn, Michael Martens, Jiaxing Huang, A. Samer Al-Homsi, Saurabh Chhabra, Edward Copelan, Miguel-Angel Diaz, Cesar O. Freytes, Robert Peter Gale, Siddhartha Ganguly, Mehdi Hamadani, Gerhard Hildebrandt, Rammurti T. Kamble, Mohamed Kharfan-Dabaja, Tamila Kindwall-Keller, Hillard M. Lazarus, David I. Marks, Taiga Nishihori, Richard F. Olsson, Ayman Saad, Saad Usmani, David H. Vesole, Jean Yared, Tomer Mark, Yago Nieto, Parameswaran Hari
Institutions: Vanderbilt University Medical Center, University of Minnesota, University of Minnesota Medical Center, Medical College of Wisconsin, Spectrum Health, Corewell Health Blodgett Hospital, Medical University of South Carolina, Carolinas Healthcare System, Levine Cancer Institute, Hospital Infantil Universitario Niño Jesús, Imperial College London, University of Kansas Medical Center, University of Kentucky, Markey Cancer Center, Baylor College of Medicine, Moffitt Cancer Center, University of Virginia Health System, University of Virginia Medical Center, University Hospitals Cleveland Medical Center, University Hospitals Seidman Cancer Center, Case Western Reserve University, University Hospitals Bristol NHS Foundation Trust, Uppsala University, Karolinska Institutet, University of Alabama at Birmingham, Hackensack University Medical Center, University of Maryland, Baltimore, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Weill Cornell Medicine, The University of Texas MD Anderson Cancer Center
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,650
Funders: Be The Match Foundation, Amgen, Genzyme, GlaxoSmithKline, Sanofi, WellPoint, Leukemia and Lymphoma Society, Fred Hutchinson Cancer Research Center, St. Baldrick's Foundation, Ariad Pharmaceuticals, Celgene, Osiris Therapeutics, Tarix Pharmaceuticals, Therakos, University of Minnesota, Blue Cross and Blue Shield Association, University of Utah, StemCyte, Medical College of Wisconsin, Otsuka America Pharmaceutical, Sigma-Tau Pharmaceuticals, Seattle Genetics, Actinium Pharmaceuticals, Chimerix, Incyte, Kiadis Pharma, Swedish Orphan Biovitrum, Medac, National Institutes of Health, Health Resources and Services Administration, Genentech, Onyx Pharmaceuticals, Allos Therapeutics, Takeda Oncology, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Center for Advancing Translational Sciences
OpenAlex ID: W2533725140