Allogeneic hematopoietic stem-cell transplantation for patients with Richter transformation: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT

  • Romain Guièze
  • Diderik-Jan Eikema
  • Linda Koster
  • Johannes Schetelig
  • Henrik Sengeloev
  • Jakob Passweg
  • Jürgen Finke
  • Mutlu Arat
  • Annoek E C Broers
  • Friedrich Stölzel
  • Jenny Byrne
  • Cristina Castilla-Llorente
  • Peter Dreger
  • Matthias Eder
  • Tobias Gedde-Dahl
  • Nicolaus Kröger
  • Josep Maria Ribera Santasusana
  • Deborah Richardson
  • Alessandro Rambaldi
  • Lucrecia Yañez
  • Michel Van Gelder
  • Joanna Drozd-Sokolowska
  • Kavita Raj
  • Ibrahim Yakoub-Agha
  • Olivier Tournilhac
  • Donal P McLornan

Abstract

Management of Richter transformation (RT) is particularly challenging, with survival estimates <1 year. We report on outcomes of 66 RT patients undergoing allogeneic-HCT (allo-HCT) between 2008 and 2018 registered with the EBMT. Median age at allo-HCT was 56.2 years (interquartile range (IQR), 51.3-63.1). Median time from RT to allo-HCT was 6.9 months (IQR, 4.9-11) and 28 (42.4%) were in complete remission (CR). The majority underwent reduced intensity conditioning (66.2%) using peripheral blood derived stem cells. Eighteen (27.3%) patients had a matched sibling donor, 24 (36.4%) a matched unrelated donor and the remaining were mismatched. Median follow-up was 6.6 years; 1- and 3- year overall and progression free survival (PFS) (95% CI) was 65% (54-77) and 39% (27-51) and 53% (41-65) and 29% (18-40), respectively. Patients in CR at time of allo-HCT had significantly better 3-year PFS (39% vs. 21%, p = 0.032). Cumulative incidences of grade II-IV acute graft versus host disease (GVHD) at day +100 was 41% (95% CI 29-53) and chronic GVHD at 3 years was 53% (95% CI 41-65). High rates of non-relapse mortality (NRM) were observed; 38% (95% CI, 26-50) at 3 years. Although potentially curative, approaches to reduce considerable NRM and chronic GVHD rates are required.

Bibliografische Daten

OriginalspracheEnglisch
ISSN0268-3369
DOIs
StatusVeröffentlicht - 07.2024

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© 2024. The Author(s), under exclusive licence to Springer Nature Limited.

PubMed 38503942