Allogeneic Hematopoietic Cell Transplantation for Chemotherapy-Unresponsive Mantle Cell Lymphoma: A Cohort Analysis from the Center for International Blood and Marrow Transplant Research

被引:63
作者
Hamadani, Mehdi [1 ]
Saber, Wael [2 ]
Ahn, Kwang Woo [2 ]
Carreras, Jeanette [2 ]
Cairo, Mitchell S. [3 ]
Fenske, Timothy S. [4 ]
Gale, Robert Peter [5 ]
Gibson, John [6 ]
Hale, Gregory A. [7 ]
Hari, Parameswaran N. [2 ]
Hsu, Jack W. [8 ,9 ]
Inwards, David J. [10 ]
Kamble, Rammurti T. [11 ]
Klein, Anderas [12 ]
Maharaj, Dipnarine [13 ]
Marks, David I. [14 ]
Rizzieri, David A. [15 ]
Savani, Bipin N. [16 ]
Schouten, Harry C. [17 ]
Waller, Edmund K. [18 ]
Wirk, Baldeep [8 ,9 ]
Lazarus, Hillard M. [19 ]
机构
[1] West Virginia Univ Hosp, Myeloma & Lymphoma Serv, Morgantown, WV USA
[2] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA
[3] Cornell, New York Presbyterian Hosp, New York, NY USA
[4] Med Coll Wisconsin, Dept Med, Div Hematol & Oncol, Milwaukee, WI 53226 USA
[5] Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Sect Hematol, London, England
[6] Royal Prince Alfred Hosp, Inst Haematol, Camperdown, NSW 2050, Australia
[7] Univ S Florida, All Childrens Hosp, St Petersburg, FL 33701 USA
[8] Shands Healthcare, Gainesville, FL USA
[9] Univ Florida, Gainesville, FL USA
[10] Mayo Clin Rochester, Rochester, MN USA
[11] Baylor Coll Med, Ctr Cell & Gene Therapy, Houston, TX 77030 USA
[12] Tufts Med Ctr, Boston, MA USA
[13] Bethesda Hlth City, Boynton Beach, FL USA
[14] Bristol Childrens Hosp, Bristol, Avon, England
[15] Duke Univ, Med Ctr, Durham, NC USA
[16] Vanderbilt Univ, Med Ctr, Brentwood, TN USA
[17] Acad Ziekenhuis Maastricht, Maastricht, Netherlands
[18] Emory Univ Hosp, Atlanta, GA 30322 USA
[19] Univ Hosp Case Med Ctr, Cleveland, OH USA
关键词
Non-Hodgkin lymphoma; Myeloablative conditioning; Reduced intensity conditioning; Chemorefractory disease; Graft-versus-host disease; PROGRESSION-FREE SURVIVAL; FOLLOW-UP; FLUDARABINE; GRAFT; CHEMOIMMUNOTHERAPY; TIUXETAN; REGIMEN; MCL;
D O I
10.1016/j.bbmt.2013.01.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with chemorefractory mantle cell lymphoma (MCL) have a poor prognosis. We used the Center for International Blood and Marrow Transplant Research database to study the outcome of 202 patients with refractory MCL who underwent allogeneic hematopoietic cell transplantation (allo-HCT) using either myeloablative (MA) or reduced-intensity/nonmyeloablative conditioning (RIC/NST), during 1998-2010. We analyzed nonrelapse mortality (NRM), progression/relapse, progression-free survival (PFS), and overall survival (OS). Seventy-four patients (median age, 54 years) received MA, and 128 patients (median age, 59 years) received RIC/NST. Median follow-up after allo-HCT was 35 months in the MA group and 43 months in the RIC/NST group. At 3 years post-transplantation, no significant between-group differences were seen in terms of NRM (47% in MA versus 43% in RIC/NST; P = .68), relapse/progression (33% versus 32%; P = .89), PFS (20% versus 25%; P = .53), or OS (25% versus 30%; P = .45). Multivariate analysis also revealed no significant between-group differences in NRM, relapse, PFS, or OS; however, receipt of a bone marrow or T cell depleted allograft was associated with an increased risk of NRM and inferior PFS and OS. Our data suggest that despite a refractory disease state, approximately 25% of patients with MCL can attain durable remission after allo-HCT, and conditioning regimen intensity does not influence outcome of allo-HCT. (C) 2013 American Society for Blood and Marrow Transplantation.
引用
收藏
页码:625 / 631
页数:7
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