Allogeneic transplantation provides durable remission in a subset of DLBCL patients relapsing after autologous transplantation

被引：113

作者：

Fenske, Timothy S. ^{[1
]}

Ahn, Kwang W. ^{[2
,3
]}

Graff, Tara M. ^{[4
]}

DiGilio, Alyssa ^{[2
]}

Bashir, Qaiser ^{[5
]}

Kamble, Rammurti T. ^{[6
]}

Ayala, Ernesto ^{[7
]}

Bacher, Ulrike ^{[8
,9
]}

Brammer, Jonathan E. ^{[5
]}

Cairo, Mitchell ^{[10
]}

Chen, Andy ^{[11
]}

Chen, Yi-Bin ^{[12
]}

Chhabra, Saurabh ^{[13
]}

D'Souza, Anita ^{[2
]}

Farooq, Umar ^{[14
]}

Freytes, Cesar ^{[15
,16
]}

Ganguly, Siddhartha ^{[17
]}

Hertzberg, Mark ^{[18
]}

Inwards, David ^{[19
]}

Jaglowski, Samantha ^{[20
]}

Kharfan-Dabaja, Mohamed A. ^{[7
]}

Lazarus, Hillard M. ^{[21
]}

Nathan, Sunita ^{[22
]}

Pawarode, Attaphol ^{[23
]}

Perales, Miguel-Angel ^{[24
]}

Reddy, Nishitha ^{[25
]}

Seo, Sachiko ^{[26
]}

Sureda, Anna ^{[27
,28
]}

Smith, Sonali M. ^{[29
]}

Hamadani, Mehdi ^{[1
,2
]}

机构：

[1] Med Coll Wisconsin, Froedtert Mem Lutheran Hosp, Milwaukee, WI 53226 USA

[2] Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA

[3] Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA

[4] Med Oncol Hematol Associates, Des Moines, IA USA

[5] Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Stem Cell Transplantat, Houston, TX 77030 USA

[6] Baylor Coll Med, Div Hematol & Oncol, Ctr Cell & Gene Therapy, Houston, TX 77030 USA

[7] H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA

[8] Univ Med Goettingen, Dept Haematol Oncol, Gottingen, Germany

[9] Univ Canc Ctr Hamburg, Interdisciplinary Clin Stem Cell Transplantat, Hamburg, Germany

[10] New York Med Coll, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, Valhalla, NY 10595 USA

[11] Oregon Hlth & Sci Univ, Ctr Hematol Malignancies, Portland, OR 97201 USA

[12] Massachusetts Gen Hosp, Div Hematol Oncol, Boston, MA 02114 USA

[13] Med Univ South Carolina, Div Hematol Oncol, Charleston, SC USA

[14] Univ Iowa Hosp & Clin, Dept Oncol & Blood Marrow Transplantat, Iowa City, IA 52242 USA

[15] South Texas Vet Hlth Care Syst, San Antonio, TX USA

[16] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA

[17] Univ Kansas, Med Ctr, Div Hematol Oncol, Blood & Marrow Transplantat, Kansas City, KS 66103 USA

[18] Prince Wales Hosp, Dept Haematol, Randwick, NSW, Australia

[19] Mayo Clin, Div Hematol, Rochester, MN USA

[20] Ohio State Univ, Med Ctr, Div Hematol, Columbus, OH 43210 USA

[21] Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA

[22] Rush Univ, Dept Hematol, Med Ctr, Chicago, IL 60612 USA

[23] Univ Michigan, Sch Med, Dept Internal Med, Blood & Marrow Transplantat Program,Div Hematol O, Ann Arbor, MI USA

[24] Mem Sloan Kettering Canc Ctr, Dept Med, Adult Bone Marrow Transplantat Serv, 1275 York Ave, New York, NY 10021 USA

[25] Vanderbilt Univ, Med Ctr, Div Hematol Oncol, Nashville, TN USA

[26] Fred Hutchinson Canc Res Ctr, Vaccine & Infect Dis Div, 1124 Columbia St, Seattle, WA 98104 USA

[27] Hosp Duran I Reynals, Serv Hematol, Inst Catala Oncol, Barcelona, Spain

[28] European Grp Blood & Marrow Transplantat, Barcelona, Spain

[29] Univ Chicago, Hematol Oncol Sect, Chicago, IL 60637 USA

来源：

BRITISH JOURNAL OF HAEMATOLOGY | 2016年 / 174卷 / 02期

关键词：

DLBCL; prognostic score; allogeneic transplantation; prior autologous transplan; B-CELL LYMPHOMA; CONDITIONING REGIMENS; REDUCED-INTENSITY; PREDICT SURVIVAL; IMPACT; RITUXIMAB; GRAFT; OUTCOMES; ORIGIN;

D O I：

10.1111/bjh.14046

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

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.

引用

页码：235 / 248

页数：14

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