Long-Term Outcomes Among 2-Year Survivors of Autologous Hematopoietic Cell Transplantation for Hodgkin and Diffuse Large B-Cell Lymphoma

被引：43

作者：

Myers, Regina M. ^{[1
]}

Hill, Brian T. ^{[2
]}

Shaw, Bronwen E. ^{[3
]}

Kim, Soyoung ^{[3
,4
]}

Millard, Heather R. ^{[3
]}

Battiwalla, Minoo ^{[5
]}

Majhail, Navneet S. ^{[6
]}

Buchbinder, David ^{[7
]}

Lazarus, Hillard M. ^{[8
]}

Savani, Bipin N. ^{[9
]}

Flowers, Mary E. D. ^{[10
]}

D'Souza, Anita ^{[3
]}

Ehrhardt, Matthew J. ^{[11
]}

Langston, Amelia ^{[12
]}

Yared, Jean A. ^{[13
]}

Hayashi, Robert J. ^{[14
]}

Daly, Andrew ^{[15
]}

Olsson, Richard F. ^{[16
,17
]}

Inamoto, Yoshihiro ^{[18
]}

Malone, Adriana K. ^{[19
]}

DeFilipp, Zachariah ^{[20
]}

Margossian, Steven P. ^{[21
,22
]}

Warwick, Anne B. ^{[23
]}

Jaglowski, Samantha ^{[24
]}

Beitinjaneh, Amer ^{[25
]}

Fung, Henry ^{[26
]}

Kasow, Kimberly A. ^{[27
]}

Marks, David I. ^{[28
]}

Reynolds, Jana ^{[29
]}

Stockerl-Goldstein, Keith ^{[30
]}

Wirk, Baldeep ^{[31
]}

Wood, William A. ^{[32
]}

Hamadani, Mehdi ^{[3
]}

Satwani, Prakash ^{[33
]}

机构：

[1] Childrens Hosp Philadelphia, Div Hematol & Oncol, Philadelphia, PA 19104 USA

[2] Cleveland Clin, Taussig Canc Inst, Dept Hematol & Med Oncol, Cleveland, OH 44106 USA

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

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

[5] NHLBI, Hematol Branch, Bethesda, MD 20892 USA

[6] Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA

[7] Childrens Hosp Orange Cty, Div Pediat Hematol, Orange, CA 92668 USA

[8] Case Western Reserve Univ, Univ Hosp Cleveland, Med Ctr, Seidman Canc Ctr, Cleveland, OH 44106 USA

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

[10] Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA

[11] St Jude Childrens Res Hosp, 332 N Lauderdale St, Memphis, TN 38105 USA

[12] Emory Univ, Winship Canc Inst, Dept Hematol & Med Oncol, Atlanta, GA 30322 USA

[13] Univ Maryland, Dept Med, Div Hematol Oncol, Greenebaum Comprehens Canc Ctr,Blood & Marrow Tra, Baltimore, MD 21201 USA

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

[15] Tom Baker Canc Clin, Calgary, AB, Canada

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

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

[18] Natl Canc Ctr, Div Hematopoiet Stem Cell Transplantat, Tokyo, Japan

[19] Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY 10029 USA

[20] Massachusetts Gen Hosp, Blood & Marrow Transplant Program, Boston, MA 02114 USA

[21] Boston Childrens Hosp, Dept Pediat Oncol, Boston, MA USA

[22] Dana Farber Canc Inst, Boston, MA 02115 USA

[23] Uniformed Serv Ind Hlth Sci, Dept Pediat, Bethesda, MD USA

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

[25] Univ Miami, Miami, FL USA

[26] Fox Chase Canc Ctr, Dept Med Oncol, 7701 Burholme Ave, Philadelphia, PA 19111 USA

[27] Univ N Carolina, Div Hematol Oncol, Dept Pediat, Chapel Hill, NC USA

[28] Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England

[29] Baylor Univ, Med Ctr, Dallas, TX USA

[30] Washington Univ, Sch Med, Div Oncol, St Louis, MO USA

[31] Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA

[32] Univ N Carolina, Div Hematol Oncol, Dept Med, Chapel Hill, NC USA

[33] Columbia Univ, Med Ctr, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, New York, NY USA

来源：

CANCER | 2018年 / 124卷 / 04期

关键词：

autologous hematopoietic cell transplant; diffuse large B-cell lymphoma; Hodgkin lymphoma; late effects; nonrelapse mortality; survival; BONE-MARROW-TRANSPLANTATION; HIGH-DOSE CHEMOTHERAPY; RELAPSE; MORTALITY; CHILDREN; ADOLESCENTS; THERAPY; TRIAL;

D O I：

10.1002/cncr.31114

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BACKGROUND: Autologous hematopoietic cell transplantation (auto-HCT) is a standard therapy for relapsed classic Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL); however, long-term outcomes are not well described. METHODS: This study analyzed survival, nonrelapse mortality, late effects, and subsequent malignant neoplasms (SMNs) in 1617 patients who survived progression-free for >= 2 years after auto-HCT for cHL or DLBCL between 1990 and 2008. The median age at auto-HCT was 40 years; the median follow-up was 10.6 years. RESULTS: The 5-year overall survival rate was 90% (95% confidence interval [CI], 87%-92%) for patients with cHL and 89% (95% CI, 87%-91%) for patients with DLBCL. The risk of late mortality in comparison with the general population was 9.6-fold higher for patients with cHL (standardized mortality ratio [SMR], 9.6) and 3.4-fold higher for patients with DLBCL (SMR, 3.4). Relapse accounted for 44% of late deaths. At least 1 late effect was reported for 9% of the patients. A total of 105 SMNs were confirmed: 44 in the cHL group and 61 in the DLBCL group. According to a multivariate analysis, older age, male sex, a Karnofsky score < 90, total body irradiation (TBI) exposure, and a higher number of lines of chemotherapy before auto-HCT were risk factors for overall mortality in cHL. Risk factors in DLBCL were older age and TBI exposure. A subanalysis of 798 adolescent and young adult patients mirrored the outcomes of the overall study population. CONCLUSIONS: Despite generally favorable outcomes, 2-year survivors of auto-HCT for cHL or DLBCL have an excess late-mortality risk in comparison with the general population and experience an assortment of late complications. (C) 2017 American Cancer Society.

引用

页码：816 / 825

页数：10

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