Reduced-Intensity Allografting as First Transplantation Approach in Relapsed/Refractory Grades One and Two Follicular Lymphoma Provides Improved Outcomes in Long-Term Survivors
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Reduced-Intensity Allografting as First Transplantation Approach in Relapsed/Refractory Grades One and Two Follicular Lymphoma Provides Improved Outcomes in Long-Term Survivors. / Klyuchnikov, Evgeny; Bacher, Ulrike; Kröger, Nicolaus-Martin; Hari, Parameswaran N; Ahn, Kwang Woo; Carreras, Jeanette; Bachanova, Veronika; Bashey, Asad; Cohen, Jonathon B; D'Souza, Anita; Freytes, César O; Gale, Robert Peter; Ganguly, Siddhartha; Hertzberg, Mark S; Holmberg, Leona A; Kharfan-Dabaja, Mohamed A; Klein, Andreas; Ku, Grace H; Laport, Ginna G; Lazarus, Hillard M; Miller, Alan M; Mussetti, Alberto; Olsson, Richard F; Slavin, Shimon; Usmani, Saad Z; Vij, Ravi; Wood, William A; Maloney, David G; Sureda, Anna M; Smith, Sonali M; Hamadani, Mehdi.
In: BIOL BLOOD MARROW TR, Vol. 21, No. 12, 04.08.2015, p. 2091-2099.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Reduced-Intensity Allografting as First Transplantation Approach in Relapsed/Refractory Grades One and Two Follicular Lymphoma Provides Improved Outcomes in Long-Term Survivors
AU - Klyuchnikov, Evgeny
AU - Bacher, Ulrike
AU - Kröger, Nicolaus-Martin
AU - Hari, Parameswaran N
AU - Ahn, Kwang Woo
AU - Carreras, Jeanette
AU - Bachanova, Veronika
AU - Bashey, Asad
AU - Cohen, Jonathon B
AU - D'Souza, Anita
AU - Freytes, César O
AU - Gale, Robert Peter
AU - Ganguly, Siddhartha
AU - Hertzberg, Mark S
AU - Holmberg, Leona A
AU - Kharfan-Dabaja, Mohamed A
AU - Klein, Andreas
AU - Ku, Grace H
AU - Laport, Ginna G
AU - Lazarus, Hillard M
AU - Miller, Alan M
AU - Mussetti, Alberto
AU - Olsson, Richard F
AU - Slavin, Shimon
AU - Usmani, Saad Z
AU - Vij, Ravi
AU - Wood, William A
AU - Maloney, David G
AU - Sureda, Anna M
AU - Smith, Sonali M
AU - Hamadani, Mehdi
N1 - Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
PY - 2015/8/4
Y1 - 2015/8/4
N2 - This study was conducted to compare long-term outcomes in patients with refractory/relapsed grades 1 and 2 follicular lymphoma (FL) after allogeneic (allo) versus autologous (auto) hematopoietic cell transplantation (HCT) in the rituximab era. Adult patients with relapsed/refractory grades 1 and 2 FL undergoing first reduced-intensity allo-HCT or first autograft during 2000 to 2012 were evaluated. A total of 518 rituximab-treated patients were included. Allo-HCT patients were younger and more heavily pretreated, and more patients had advanced stage and chemoresistant disease. The 5-year adjusted probabilities, comparing auto-HCT versus allo-HCT groups for nonrelapse mortality (NRM) were 5% versus 26% (P < .0001); relapse/progression: 54% versus 20% (P < .0001); progression-free survival (PFS): 41% versus 58% (P < .001), and overall survival (OS): 74% versus 66% (P = .05). Auto-HCT was associated with a higher risk of relapse/progression beyond 5 months after HCT (relative risk [RR], 4.4; P < .0001) and worse PFS (RR, 2.9; P < .0001) beyond 11 months after HCT. In the first 24 months after HCT, auto-HCT was associated with improved OS (RR, .41; P < .0001), but beyond 24 months, it was associated with inferior OS (RR, 2.2; P = .006). A landmark analysis of patients alive and progression-free at 2 years after HCT confirmed these observations, showing no difference in further NRM between both groups, but there was significantly higher risk of relapse/progression (RR, 7.3; P < .0001) and inferior PFS (RR, 3.2; P < .0001) and OS (RR, 2.1; P = .04) after auto-HCT. The 10-year cumulative incidences of second hematological malignancies after allo-HCT and auto-HCT were 0% and 7%, respectively. Auto-HCT and reduced-intensity-conditioned allo-HCT as first transplantation approach can provide durable disease control in grades 1 and 2 FL patients. Continued disease relapse risk after auto-HCT translates into improved PFS and OS after allo-HCT in long-term survivors.
AB - This study was conducted to compare long-term outcomes in patients with refractory/relapsed grades 1 and 2 follicular lymphoma (FL) after allogeneic (allo) versus autologous (auto) hematopoietic cell transplantation (HCT) in the rituximab era. Adult patients with relapsed/refractory grades 1 and 2 FL undergoing first reduced-intensity allo-HCT or first autograft during 2000 to 2012 were evaluated. A total of 518 rituximab-treated patients were included. Allo-HCT patients were younger and more heavily pretreated, and more patients had advanced stage and chemoresistant disease. The 5-year adjusted probabilities, comparing auto-HCT versus allo-HCT groups for nonrelapse mortality (NRM) were 5% versus 26% (P < .0001); relapse/progression: 54% versus 20% (P < .0001); progression-free survival (PFS): 41% versus 58% (P < .001), and overall survival (OS): 74% versus 66% (P = .05). Auto-HCT was associated with a higher risk of relapse/progression beyond 5 months after HCT (relative risk [RR], 4.4; P < .0001) and worse PFS (RR, 2.9; P < .0001) beyond 11 months after HCT. In the first 24 months after HCT, auto-HCT was associated with improved OS (RR, .41; P < .0001), but beyond 24 months, it was associated with inferior OS (RR, 2.2; P = .006). A landmark analysis of patients alive and progression-free at 2 years after HCT confirmed these observations, showing no difference in further NRM between both groups, but there was significantly higher risk of relapse/progression (RR, 7.3; P < .0001) and inferior PFS (RR, 3.2; P < .0001) and OS (RR, 2.1; P = .04) after auto-HCT. The 10-year cumulative incidences of second hematological malignancies after allo-HCT and auto-HCT were 0% and 7%, respectively. Auto-HCT and reduced-intensity-conditioned allo-HCT as first transplantation approach can provide durable disease control in grades 1 and 2 FL patients. Continued disease relapse risk after auto-HCT translates into improved PFS and OS after allo-HCT in long-term survivors.
U2 - 10.1016/j.bbmt.2015.07.028
DO - 10.1016/j.bbmt.2015.07.028
M3 - SCORING: Journal article
C2 - 26253007
VL - 21
SP - 2091
EP - 2099
JO - BIOL BLOOD MARROW TR
JF - BIOL BLOOD MARROW TR
SN - 1083-8791
IS - 12
ER -