The Impact of Graft-versus-Host Disease on the Relapse Rate in Patients with Lymphoma Depends on the Histological Subtype and the Intensity of the Conditioning Regimen

被引：47

作者：

Urbano-Ispizua, Alvaro ^{[1
,2
]}

Pavletic, Steven Z. ^{[3
]}

Flowers, Mary E. ^{[4
]}

Klein, John P. ^{[5
,6
]}

Zhang, Mei-Jie ^{[5
,6
]}

Carreras, Jeanette ^{[5
]}

Montoto, Silvia ^{[7
]}

Perales, Miguel-Angel ^{[8
]}

Aljurf, Mahmoud D. ^{[9
]}

Akpek, Goerguen ^{[10
]}

Bredeson, Christopher N. ^{[11
,12
]}

Costa, Luciano J. ^{[13
]}

Dandoy, Christopher ^{[14
]}

Freytes, Cesar O. ^{[15
,16
]}

Fung, Henry C. ^{[17
]}

Gale, Robert Peter ^{[18
]}

Gibson, John ^{[19
]}

Hamadani, Mehdi ^{[5
]}

Hayashi, Robert J. ^{[20
]}

Inamoto, Yoshihiro ^{[4
]}

Inwards, David J. ^{[21
]}

Lazarus, Hillard M. ^{[22
]}

Maloney, David G. ^{[4
]}

Martino, Rodrigo ^{[23
]}

Munker, Reinhold ^{[24
]}

Nishihori, Taiga ^{[25
]}

Olsson, Richard F. ^{[26
,27
]}

Rizzieri, David A. ^{[28
]}

Reshef, Ran ^{[29
]}

Saad, Ayman ^{[13
]}

Savani, Bipin N. ^{[30
]}

Schouten, Harry C. ^{[31
]}

Smith, Sonali M. ^{[32
]}

Socie, Gerard ^{[33
]}

Wirk, Baldeep ^{[34
]}

Yu, Lolie C. ^{[35
]}

Saber, Wael ^{[5
]}

机构：

[1] Univ Barcelona, Hosp Clin, IDIBAPS, Dept Hematol, Barcelona, Spain

[2] Inst Res Josep Carreras, Barcelona, Spain

[3] NCI, Expt Transplantat & Immunol Branch, Ctr Canc Res, Bethesda, MD 20892 USA

[4] Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA

[5] Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA

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

[7] Barts Hlth NHS Trust, St Bartholomews Hosp, Dept Haematooncol, London, England

[8] Mem Sloan Kettering Canc Ctr, Dept Med, Bone Marrow Transplant Serv, New York, NY 10021 USA

[9] King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia

[10] Banner MD Anderson Canc Ctr, Hematol Oncol Sect, Gilbert, AZ USA

[11] Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada

[12] Ottawa Hosp, Res Inst, Ottawa, ON, Canada

[13] Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA

[14] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 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] Temple Hlth, Fox Chase Canc Ctr, Dept Med Oncol, Philadelphia, PA USA

[18] Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England

[19] Royal Prince Alfred Hosp, Inst Haematol, Camperdown, NSW 2050, Australia

[20] Washington Univ, Sch Med, Dept Pediat, Div Pediat Hematol Oncol, St Louis, MO 63110 USA

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

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

[23] Hosp Santa Creu & Sant Pau, Div Hematol, Barcelona, Spain

[24] Louisiana State Univ Hlth, Dept Internal Med, Div Hematol Oncol, Shreveport, LA USA

[25] Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Med Oncol, Tampa, FL 33612 USA

[26] Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden

[27] Uppsala Univ, Ctr Clin Res Sormland, Uppsala, Sweden

[28] Duke Univ, Div Hematol Malignancies & Cellular Therapy, Durham, NC USA

[29] Univ Penn, Dept Med, Abramson Canc Ctr, Med Ctr, Philadelphia, PA 19104 USA

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

[31] Acad Ziekenhuis, Dept Hematol, Maastricht, Netherlands

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

[33] Hop St Louis, Dept Hematol, Paris, France

[34] SUNY Stony Brook, Med Ctr, Dept Internal Med, Stony Brook, NY 11794 USA

[35] Louisiana State Univ, Med Ctr, Childrens Hosp, Div Hematol Oncol,Ctr Canc & Blood Disorders, New Orleans, LA USA

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2015年 / 21卷 / 10期

关键词：

Graft-versus-host disease; Lymphoma; STEM-CELL TRANSPLANTATION; BONE-MARROW TRANSPLANT; ALLOGENEIC TRANSPLANTATION; HODGKINS-LYMPHOMA; EUROPEAN GROUP; BLOOD; INFUSIONS; REMISSIONS; REGISTRY;

D O I：

10.1016/j.bbmt.2015.05.010

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The purpose of this study was to analyze the impact of graft-versus-host disease (GVHD) on the relapse rate of different lymphoma subtypes after allogeneic hematopoietic cell transplantation (allo-HCT). Adult patients with a diagnosis of Hodgkin lymphoma, diffuse large B cell lymphoma, follicular lymphoma (FL), peripheral T cell lymphoma, or mantle cell lymphoma (MCL) undergoing HLA-identical sibling or unrelated donor hematopoietic cell transplantation between 1997 and 2009 were included. Two thousand six hundred eleven cases were included. A reduced-intensity conditioning (RIC) regimen was used in 62.8% of the transplantations. In a multivariate analysis of myeloablative cases (n = 970), neither acute (aGVHD) nor chronic GVHD (cGVHD) were significantly associated with a lower incidence of relapse/progression in any lymphoma subtype. In contrast, the analysis of RIC cases (n = 1641) showed that cGVHD was associated with a lower incidence of relapse/progression in FL (risk ratio [RR],.51; P = 3.049) and in MCL (RR,.41; P = .019). Patients with FL or MCL developing both aGVHD and cGVHD had the lowest risk of relapse (RR,.14; P = .007; and RR,.15; P = .0019, respectively). Of interest, the effect of GVHD on decreasing relapse was similar in patients with sensitive disease and chemoresistant disease. Unfortunately, both aGVHD and cGVHD had a deleterious effect on treatment-related mortality and overall survival (OS) in FL cases but did not affect treatment-related mortality, OS or PFS in MCL. This study reinforces the use of RIC allo-HCT as a platform for immunotherapy in FL and MCL patients. (C) 2015 American Society for Blood and Marrow Transplantation.

引用

页码：1746 / 1753

页数：8

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