Outcome in patients with diffuse large B-cell lymphoma who relapse after autologous stem cell transplantation and receive active therapy. A retrospective analysis of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

被引：36

作者：

Gonzalez-Barca, E. ^{[1
]}

Boumendil, A. ^{[2
]}

Blaise, D. ^{[3
]}

Trneny, M. ^{[4
]}

Masszi, T. ^{[5
]}

Finel, H. ^{[2
]}

Michieli, M. G. ^{[6
]}

Bittenbring, J. T. ^{[7
]}

Gritti, G. ^{[8
]}

Snowden, J. A. ^{[9
]}

Bishton, M. ^{[10
]}

Bruno, B. ^{[11
]}

Gonzalez de Villambrosia, S. ^{[12
]}

Janikova, A. ^{[13
]}

Leleu, X. ^{[14
]}

Anagnostopoulos, A. ^{[15
,16
]}

Poire, X. ^{[17
]}

Crysandt, M. ^{[18
]}

Ozkurt, Z. N. ^{[19
]}

Vandenberghe, E. ^{[20
,21
]}

Itala-Remes, M. ^{[22
]}

Cahn, J. Y. ^{[23
]}

Jantunen, E. ^{[24
,25
,26
]}

Schroyens, W. ^{[27
]}

Maertens, J. ^{[28
]}

Esquirol, A. ^{[29
]}

Dreger, P. ^{[30
]}

Montoto, S. ^{[31
]}

Sureda, A. ^{[1
]}

机构：

[1] Hosp Duran i Reynals, Inst Catala Oncol, IDIBELL, Barcelona, Spain

[2] EBMT Paris Study Off, Paris, France

[3] Inst Paoli Calmettes, Dept Hematol, Marseille, France

[4] 1st Charles Univ Gen Hosp, Prague, Czech Republic

[5] St Istvan & St Laszlo Hosp, Budapest, Hungary

[6] Ctr Riferimento Oncol, Aviano, Italy

[7] Univ Saarland, Homburg, Germany

[8] Papa Giovanni XXIII Hosp, Bergamo, Italy

[9] Sheffield Teaching Hosp, Sheffield, S Yorkshire, England

[10] Nottingham Univ Hosp NHS Trust, Dept Hematol, Nottingham, England

[11] Univ Torino, Dept Mol Biotechnol & Hlth Sci, AOU Citta Salute & Sci, Turin, Italy

[12] Hosp Univ Marques Valdecilla, Dept Hematol, Santander, Spain

[13] Univ Hosp Brno, Dept Hematol & Oncol, Brno, Czech Republic

[14] Hop La Miletrie, Serv Hematol & Therapie Cellulaire, Poitiers, France

[15] G Papanikolaou Hosp, Hematol Dept, Thessaloniki, Greece

[16] G Papanikolaou Hosp, HCT Unit, Thessaloniki, Greece

[17] Clin Universitaires St Luc, Sect Hematol, Brussels, Belgium

[18] Univ Hosp RWTH Aachen Univ, Dept Hematol Oncol Hemostaseol & Stem Cell Transp, Aachen, Germany

[19] Gazi Univ, Fac Med, Ankara, Turkey

[20] St James Hosp, Dublin, Ireland

[21] Trinity Coll Dublin, Dublin, Ireland

[22] Turku Univ Hosp, Stem Cell Transplantat Unit, Turku, Finland

[23] Hop A Michallon, Dept Hematol, Grenoble, Fra, France

[24] Univ Eastern Finland, Inst Clin Med, Internal Med, Kuopio, Finland

[25] Kuopio Univ Hosp, Dept Med, Kuopio, Finland

[26] Siunsote North Carelia Hosp Dist, Joensuu, Finland

[27] Univ Antwerp, Antwerp Univ Hosp, Dept Hematol, Antwerp, Belgium

[28] Univ Hosp Gasthuisberg, Dept Hematol, Leuven, Belgium

[29] Hosp Santa Creu & Sant Pau, Clin Hematol Serv, Barcelona, Spain

[30] Heidelberg Univ, Dept Med 5, Heidelberg, Germany

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

来源：

BONE MARROW TRANSPLANTATION | 2020年 / 55卷 / 02期

关键词：

CHEMOTHERAPY PLUS RITUXIMAB; NON-HODGKIN-LYMPHOMA; MULTICENTER; PROGRESSION; CHOP;

D O I：

10.1038/s41409-019-0650-x

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

Autologous hematopoietic stem cell transplantation (auto-HSCT) is the standard of care for patients with diffuse large B-cell lymphoma (DLBCL) who relapse/progress after first line chemoimmunotherapy. Long-term outcome of those who relapse after transplant is poor. We present the results of a retrospective study of 256 adult patients reported to the EBMT registry with DLBCL who relapsed after auto-HSCT performed between 2003 and 2013, and who received active salvage strategies. One hundred and fifty-four (60%) were male; median age was 53 years. Median time to relapse was 7 months, 65% relapsed during the first year. Overall response rate after salvage therapy was 46%. Median follow-up after first salvage therapy was 40 months (IQR 23-63 months). Overall survival (OS) at 3 years was 27% (95% CI 22-33). OS at 3 years of patients relapsing longer than 1 year after auto-HSCT was 41% (95% CI 31-53) compared with 20% (95% CI 14-24) in those who relapsed in less than 1 year. Eighty-two patients (32%) had a second HSCT, an allogeneic HSCT (allo-HSCT) in 69 cases, at a median time of 6.5 months after relapse. OS at 3 years after allo-HSCT was 36% (95% CI 25-51). In conclusion, the prognosis of patients with DLBCL that relapse after auto-HSCT is dismal. Patients who relapse in less than 1 year remain an unmet need, and should be considered for CAR T cell therapy or clinical trials. Patients who relapse after 1 year can be rescued with salvage therapies and a second HSCT. These results provide a benchmark to compare data of new prospective studies.

引用

页码：393 / 399

页数：7

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