Citations 2
Impact of pre‐transplant depression on outcomes of allogeneic and autologous hematopoietic stem cell transplantation
El‐Jawahri, Areej , Chen, Yi‐Bin, Brazauskas, Ruta , He, Naya, Lee, Stephanie J. , Knight, Jennifer M. , Majhail, Navneet S. , Buchbinder, David , Schears, Raquel M. , Wirk, Baldeep , Wood, William A. , Ahmed, Ibrahim , Aljurf, Mahmoud , Beattie, Sara , Dandoy, Christopher E. , Díaz, Miguel Ángel , D’Souza, Anita , Freytes, César O. , Gajewski, James , Hashmi, Shahrukh K. , Jakubowski, Ann A. , Kamble, Rammurti T., Kindwall‐Keller, Tamila L. , Lazarus, Hilard M., Malone, Adriana K. , Marks, David I. , Meehan, Kenneth R., Olsson, Richard F. , Rizzieri, David A. , Steinberg, Amir , Speckhart, Dawn, Szwajcer, David , Schoemans, Hélène , Seo, Sachiko , Üstün, Celalettin , Dalal, Jignesh , Sales‐Bonfim, Carmem, Khera, Nandita , Hahn, Theresa , Saber, Wael , Chen, Yi‐Bin , Szer, Jeff , Battiwalla, Minoo , Gergis, Usama , Savani, Bipin N. , Atsuta, Yoshiko , D'Souza, Anita , Olsson, Richard F , Majhail, Navneet S , Knight, Jennifer M , Diaz Perez, Miguel Angel , Dandoy, Christopher E , Lee, Stephanie J , Wood, William A
Cancer | January 19, 2017 | Volume: 123 | Issue: 10 | Pages: 1828-1838
BACKGROUNDTo evaluate the impact of depression before autologous and allogeneic hematopoietic cell transplantation (HCT) on clinical outcomes post‐transplantation.METHODSWe analyzed data from the Center for International Blood and Marrow Transplant Research to compare outcomes after autologous (n = 3786) or allogeneic (n = 7433) HCT for adult patients with hematologic malignancies with an existing diagnosis of pre‐HCT depression requiring treatment versus those without pre‐HCT depression. Using Cox regression models, we compared overall survival (OS) between patients with or without depression. We compared the number of days alive and out of the hospital in the first 100 days post‐HCT using Poisson models. We also compared the incidence of grade 2‐4 acute and chronic graft‐versus‐host disease (GVHD) in allogeneic HCT.RESULTSThe study included 1116 (15%) patients with pre‐transplant depression and 6317 (85%) without depression who underwent allogeneic HCT between 2008 and 2012. Pre‐transplant depression was associated with lower OS (hazard ratio [HR], 1.13; 95% confidence interval [CI], 1.04‐1.23; P = 0.004) and a higher incidence of grade 2‐4 acute GVHD (HR, 1.25; 95% CI, 1.14‐1.37; P < 0.0001), but similar incidence of chronic GVHD. Pre‐transplant depression was associated with fewer days‐alive‐and‐out‐of‐the hospital (means ratio [MR] = 0.97; 95% CI, 0.95‐0.99; P = 0.004). There were 512 (13.5%) patients with Pre‐transplant depression and 3274 (86.5%) without depression who underwent autologous HCT. Pre‐transplant depression in autologous HCT was not associated with OS (HR, 1.15; 95% CI, 0.98‐1.34; P = 0.096) but was associated with fewer days alive and out of the hospital (MR, 0.98; 95% CI, 0.97‐0.99; P = 0.002).CONCLUSIONPre‐transplant depression was associated with lower OS and higher risk of acute GVHD among allogeneic HCT recipients and fewer days alive and out of the hospital during the first 100 days after autologous and allogeneic HCT. Patients with pre‐transplant depression represent a population that is at risk for post‐transplant complications. Cancer 2017;123:1828–1838. © 2017 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 .