Citations 2
Autologous haematopoietic cell transplantation for non‐Hodgkin lymphoma with secondary CNS involvement
Wang, Zhiwei , Zhang, Mei‐Jie , Bolwell, Brian J., Chen, Andy I. , Fenske, Timothy S. , Freytes, César O. , Gibson, John, Hayes‐Lattin, Brandon , Holmberg, Leona , Inwards, David J. , Isola, Luis , Khoury, H. Jean , Lewis, Victor , Maharaj, Dipnarine , Munker, Reinhold , Phillips, Gordon L., Rizzieri, David A. , Rowlings, Philip A., Saber, Wael , Satwani, Prakash , Waller, Edmund K. , Maloney, David G. , Montoto, Silvia , Laport, Ginna G. , Hari, Parameswaran , Holmberg, Leona , Chen, Andy , Maziarz, Richard Thomas , Gale, Robert Peter , Vose, Julie M. , Lazarus, Hillard M. , Waller, Edmund K , Montoto, Silvia , Hari, Parameswaran
British Journal of Haematology | July 6, 2013 | Volume: 162 | Issue: 5 | Pages: 648-656
SummaryPre‐existing central nervous system (CNS) involvement may influence referral for autologous haematopoietic cell transplantation (AHCT) for patients with non‐Hodgkin lymphoma (NHL). The outcomes of 151 adult patients with NHL with prior secondary CNS involvement (CNS+) receiving an AHCT were compared to 4688 patients without prior CNS lymphoma (CNS−). There were significant baseline differences between the cohorts. CNS+ patients were more likely to be younger, have lower performance scores, higher age‐adjusted international prognostic index scores, more advanced disease stage at diagnosis, more aggressive histology, more sites of extranodal disease, and a shorter interval between diagnosis and AHCT. However, no statistically significant differences were identified between the two groups by analysis of progression‐free survival (PFS) and overall survival (OS) at 5 years. A matched pair comparison of the CNS+ group with a subset of CNS− patients matched on propensity score also showed no differences in outcomes. Patients with active CNS lymphoma at the time of AHCT (n = 55) had a higher relapse rate and diminished PFS and OS compared with patients whose CNS lymphoma was in remission (n = 96) at the time of AHCT. CNS+ patients can achieve excellent long‐term outcomes with AHCT. Active CNS lymphoma at transplant confers a worse prognosis.
Allogeneic transplantation for therapy-related myelodysplastic syndrome and acute myeloid leukemia
Litzow, Mark R. , Tarima, Sergey , Pérez, Waleska S., Bolwell, Brian J., Cairo, Mitchell S. , Camitta, Bruce M., Luger, Selina M. , Marks, David I. , Pasquini, Marcelo C. , Phillips, Gordon L., Rizzo, J. Douglas , Sierra, Jorge , Tallman, Martin S. , Weisdorf, Daniel J. , Cutler, Corey S. , Lima, Marcos de , DiPersio, John F. , Gale, Robert Peter , Keating, Armand , Lazarus, Hillard M. , Maziarz, Richard Thomas , McCarthy, Philip L. , Weisdorf, Dan
Blood | December 24, 2009 | Volume: 115 | Issue: 9 | Pages: 1850-1857
Abstract Therapy-related myelodysplastic syndromes (t-MDSs) and acute myeloid leukemia (t-AML) have a poor prognosis with conventional therapy. Encouraging results are reported after allogeneic transplantation. We analyzed outcomes in 868 persons with t-AML (n = 545) or t-MDS (n = 323) receiving allogeneic transplants from 1990 to 2004. A myeloablative regimen was used for conditioning in 77%. Treatment-related mortality (TRM) and relapse were 41% (95% confidence interval [CI], 38-44) and 27% (24-30) at 1 year and 48% (44-51) and 31% (28-34) at 5 years, respectively. Disease-free (DFS) and overall survival (OS) were 32% (95% CI, 29-36) and 37% (34-41) at 1 year and 21% (18-24) and 22% (19-26) at 5 years, respectively. In multivariate analysis, 4 risk factors had adverse impacts on DFS and OS: (1) age older than 35 years; (2) poor-risk cytogenetics; (3) t-AML not in remission or advanced t-MDS; and (4) donor other than an HLA-identical sibling or a partially or well-matched unrelated donor. Five-year survival for subjects with none, 1, 2, 3, or 4 of these risk factors was 50% (95% CI, 38-61), 26% (20-31), 21% (16-26), 10% (5-15), and 4% (0-16), respectively (P < .001). These data permit a more precise prediction of outcome and identify subjects most likely to benefit from allogeneic transplantation.