Allogeneic transplantation provides durable remission in a subset of DLBCL patients relapsing after autologous transplantation
Year: 2016
Type: article
Study design: Observational Study
Abstract: For diffuse large B-cell lymphoma (DLBCL) patients progressing after autologous haematopoietic cell transplantation (autoHCT), allogeneic HCT (alloHCT) is often considered, although limited information is available to guide patient selection. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified 503 patients who underwent alloHCT after disease progression/relapse following a prior autoHCT. The 3-year probabilities of non-relapse mortality, progression/relapse, progression-free survival (PFS) and overall survival (OS) were 30, 38, 31 and 37% respectively. Factors associated with inferior PFS on multivariate analysis included Karnofsky performance status (KPS) <80, chemoresistance, autoHCT to alloHCT interval <1-year and myeloablative conditioning. Factors associated with worse OS on multivariate analysis included KPS<80, chemoresistance and myeloablative conditioning. Three adverse prognostic factors were used to construct a prognostic model for PFS, including KPS<80 (4 points), autoHCT to alloHCT interval <1-year (2 points) and chemoresistant disease at alloHCT (5 points). This CIBMTR prognostic model classified patients into four groups: low-risk (0 points), intermediate-risk (2-5 points), high-risk (6-9 points) or very high-risk (11 points), predicting 3-year PFS of 40, 32, 11 and 6%, respectively, with 3-year OS probabilities of 43, 39, 19 and 11% respectively. In conclusion, the CIBMTR prognostic model identifies a subgroup of DLBCL patients experiencing long-term survival with alloHCT after a failed prior autoHCT.
Source: British Journal of Haematology
DOI: 10.1111/bjh.14046
Authors: Timothy S. Fenske, Kwang W. Ahn, Tara M. Graff, Alyssa DiGilio, Qaiser Bashir, Rammurti T. Kamble, Ernesto Ayala, Ulrike Bacher, Jonathan E. Brammer, Mitchell Cairo, Andy Chen, Yi‐Bin Chen, Saurabh Chhabra, Anita D'Souza, Umar Farooq, Cesar Freytes, Siddhartha Ganguly, Mark Hertzberg, David Inwards, Samantha Jaglowski, Mohamed A. Kharfan‐Dabaja, Hillard M. Lazarus, Sunita Nathan, Attaphol Pawarode, Miguel‐Angel Perales, Nishitha Reddy, Sachiko Seo, Anna Sureda, Sonali M. Smith, Mehdi Hamadani
Institutions: Froedtert Hospital, Medical College of Wisconsin, The University of Texas MD Anderson Cancer Center, Baylor College of Medicine, Moffitt Cancer Center, Universitätsmedizin Göttingen, University Cancer Center Hamburg, University of Göttingen, New York Medical College, Oregon Health & Science University, Massachusetts General Hospital, Medical University of South Carolina, University of Iowa Hospitals and Clinics, The University of Texas at San Antonio Health Science Center, South Texas Veterans Health Care System, University of Kansas Medical Center, Prince of Wales Hospital, Mayo Clinic, The Ohio State University Wexner Medical Center, University Hospitals Cleveland Medical Center, University Hospitals Seidman Cancer Center, Rush University Medical Center, University of Michigan, Michigan Medicine, Memorial Sloan Kettering Cancer Center, Vanderbilt University Medical Center, Fred Hutch Cancer Center, Institut Català d'Oncologia, Duran i Reynals Hospital, University of Chicago
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Roswell Park Cancer Institute, Genzyme, GlaxoSmithKline, Merck, WellPoint, Leukemia and Lymphoma Society, Health Research, Fred Hutchinson Cancer Research Center, St. Baldrick's Foundation, Celgene, Tarix Pharmaceuticals, Therakos, University of Minnesota, Blue Cross and Blue Shield Association, University of Utah, StemCyte, Medical College of Wisconsin, Otsuka America Pharmaceutical, Kiadis Pharma, Health Resources and Services Administration, Genentech, Onyx Pharmaceuticals, Japan Society for the Promotion of Science, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases
Awards: G2220088171, G2814340220, G3231857129, Identification of reactivation factors for human herpes viruses, Blood & Marrow Transplant Clinical Trials Network Data Coordinating Center, Cancer Center Support Grant, A Data Resource for Blood and Marrow Transplants and Adoptive Cellular Therapy Research
OpenAlex ID: W2300560420