Citations 2
Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure
Smith, Sonali M. , Godfrey, James , Ahn, Kwang Woo , Digilio, Alessandro, Ahmed, Sairah , Bachanová, Veronika , Bashey, Asad, Bolaños‐Meade, Javier , Cairo, Mitchell S. , Chen, Andy , Copelan, Edward A. , Aljurf, Mahmoud , Farooq, Umar , Ganguly, Siddhartha , Holmberg, Leona , Inwards, David J. , Kanate, Abraham S. , Karmali, Reem , Kenkre, Vaishalee P. , Kharfan‐Dabaja, Mohamed A. , Klein, Andreas K. , Mei, Matthew , Geethakumari, Praveen Ramakrishnan , Saad, Ayman , Schouten, Harry C. , Shah, Nirav N. , Urbano-Ispizúa, Álvaro , Vij, Ravi , Sureda, Anna , Holmberg, Leona , Bachanova, Veronika , Inwards, David, Mussetti, Alberto , Savani, Bipin N , Sureda, Anna , Hamadani, Mehdi , Chen, Andy I. , Saad, Ayman , Mei, Matthew , Farooq, Umar , Ahmed, Sairah , Karmali, Reem , Agrawal, Vaibhav , Bacher, Ulrike , Chhabra, Saurabh , Dahi, Parastoo B , Hertzberg, Mark , Lazarus, Hillard M. , Mussetti, Alberto , Nishihori, Taiga , Savani, Bipin N. , Vose, Julie M. , Hamadani, Mehdi
Cancer | April 12, 2018 | Volume: 124 | Issue: 12 | Pages: 2541-2551
BACKGROUNDEarly treatment failure (ETF) in follicular lymphoma (FL), defined as relapse or progression within 2 years of frontline chemoimmunotherapy, is a newly recognized marker of poor survival and identifies a high‐risk group of patients with an expected 5‐year overall survival (OS) rate of approximately 50%. Transplantation is an established option for relapsed FL, but its efficacy in this specific ETF FL population has not been previously evaluated.METHODSThis study compared autologous hematopoietic stem cell transplantation (auto‐HCT) with either matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic hematopoietic cell transplantation (allo‐HCT) as the first transplantation approach for patients with ETF FL (age ≥ 18 years) undergoing auto‐HCT or allo‐HCT between 2002 and 2014. The primary endpoint was OS. The secondary endpoints were progression‐free survival, relapse, and nonrelapse mortality (NRM).RESULTSFour hundred forty FL patients had ETF (auto‐HCT, 240; MSD hematopoietic stem cell transplantation [HCT], 105; and MUD HCT, 95). With a median follow‐up of 69 to 73 months, the adjusted probability of 5‐year OS was significantly higher after auto‐HCT (70%) or MSD HCT (73%) versus MUD HCT (49%; P = .0008). The 5‐year adjusted probability of NRM was significantly lower for auto‐HCT (5%) versus MSD (17%) or MUD HCT (33%; P < .0001). The 5‐year adjusted probability of disease relapse was lower with MSD (31%) or MUD HCT (23%) versus auto‐HCT (58%; P < .0001).CONCLUSIONSPatients with high‐risk FL, as defined by ETF, undergoing auto‐HCT for FL have low NRM and a promising 5‐year OS rate (70%). MSD HCT has lower relapse rates than auto‐HCT but similar OS. Cancer 2018;124:2541‐51. © 2018 American Cancer Society.
Allogeneic transplantation provides durable remission in a subset of DLBCL patients relapsing after autologous transplantation
Fenske, Timothy S. , Ahn, Kwang Woo , Graff, Tara M., Digilio, Alessandro, Kamble, Rammurti T., Ayala, Ernesto , Brammer, Jonathan E. , Cairo, Mitchell S. , Chen, Andy , Chen, Yi‐Bin, D’Souza, Anita , Farooq, Umar , Freytes, Cesar, Ganguly, Siddhartha , Inwards, David J. , Kharfan‐Dabaja, Mohamed A. , Nathan, Sunita , Pawarode, Attaphol , Reddy, Nishitha , Seo, Sachiko , Sureda, Anna , Smith, Sonali M. , Inwards, David, Bashir, Qaiser , Bacher, Ulrike , Chen, Yi‐Bin , Chhabra, Saurabh , Farooq, Umar , Hertzberg, Mark , Jaglowski, Samantha , Lazarus, Hillard M. , Perales, Miguel‐Angel , Hamadani, Mehdi , Chen, Andy I. , D'Souza, Anita
British Journal of Haematology | March 18, 2016 | Volume: 174 | Issue: 2 | Pages: 235-248
Summary For diffuse large B‐cell lymphoma ( DLBCL ) patients progressing after autologous haematopoietic cell transplantation (auto HCT ), allogeneic HCT (allo HCT ) 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 allo HCT after disease progression/relapse following a prior auto HCT . 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, auto HCT to allo HCT 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), auto HCT to allo HCT interval <1‐year (2 points) and chemoresistant disease at allo HCT (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 allo HCT after a failed prior auto HCT .