Allogeneic Hematopoietic Stem Cell Transplantation in Transformed Follicular Lymphoma (tFL): Results of a Retrospective Multicenter Study from GELTAMO/GETH-TC Spanish Groups
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Objectives
2.2. Patient Enrollment
2.3. Study Endpoints and Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Donors
3.3. Engraftmet and Chimerism
3.4. Graft-Versus-Host Disease
3.5. Response and Relapse Rate
3.6. Overall and Progression-Free Survival
3.7. Global Mortality and Non-Relapse Mortality
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Frequency (Range or Percentage) | |
---|---|---|
Age, median (range) | 52 (31–66) | |
Sex, n (%) | Male | 24 (63%) |
Female | 14 (37%) | |
Previous lines of treatment, median (range) | 4 (2–7) | |
Previous lines of treatment, n (%) | 2 | 5 (13%) |
3 | 14 (37%) | |
4 or more | 19 (50%) | |
Previous ASCT, n (%) | Yes | 24 (63%) |
No | 14 (37%) | |
Lymphoma status pre-AlloSCT, n (%) | CR | 21 (55%) |
PR | 12 (32%) | |
SD/PD | 4 (11%) | |
Data not available | 1 (2%) | |
HCT-CI, n (%) | 0 | 17 (44.7%) |
1 | 10 (26.3%) | |
2 | 3 (7.9%) | |
≥3 | 6 (15.8%) | |
Data not available | 2 (5.3) | |
HLA identical and donor, n (%) | Identical donor | 26 (68%) |
Related | 21 (56%) | |
Unrelated | 5 (12%) | |
Haploidentical | 7 (18%) | |
Mismatched donor unrelated | 3 (8%) | |
Data not available | 2 (5%) | |
Source of stem cells, n (%) | PB | 36 (95%) |
BM | 1 (2.5%) | |
CBU | 1 (2.5%) | |
Intensity conditioning regimen, n (%) | Myeloablative (MAC) | 10 (23.3%) |
Reduced intensity (RIC) | 26 (68.4%) | |
Data not available | 2 (5.3%) | |
Conditioning regimen, n (%) | Flu-Mel | 21 (55.3%) |
Flu-Bu | 4 (23.7%) | |
Flu-Bu-Thio | 4 (10.5%) | |
CyTBI | 1 (2.6%) | |
Flu-TBI | 2 (5.2%) | |
Bu-Cy | 1 (2.6%) | |
Monoclonal antibodies as part of conditioning regimen, n (%) | Rituximab | 2 (5.3%) |
Ofatumumab | 7 (18.4%) | |
Ibritumomab tiuxetan | 2 (5.3%) | |
GVHD prophylaxis, n (%) | MTX + CI | 13 (34.2%) |
Tacro + Rapa | 11 (28.9%) | |
MMF + CI | 4 (10.6%) | |
Cy post-alloSCT | 7 (18.4%) | |
Alemtuzumab/ATG | 2 (5.3%) |
Status at alloSCT | Response at Day +100 | Status at Last Follow-Up | Cause of Death |
---|---|---|---|
CR, n = 21 | CR, n = 19 | Alive in CR, n = 10 | |
Death while in CR, n = 8 | Infection, n = 5 aGVHD n = 2 Secondary neoplasm, n = 1 | ||
Death after progression, n = 1 | Lymphoma, n = 1 | ||
Relapse, n = 1 | Death, n = 1 | Lymphoma, n = 1 | |
Death without evaluation, n = 1 | Death, n = 1 | SOS, n = 1 | |
PR, n = 12 | CR, n = 5 | Alive in CR, n = 1 | |
Death in CR, n = 2 | Infection, n = 2 | ||
Death after progression, n = 2 | Lymphoma, n = 2 | ||
PR, n = 3 | Alive in CR, n = 2 * | ||
Death in CR, n = 1 | NRM, n = 1 | ||
SD/PD, n = 3 | Death, n = 3 | Lymphoma, n = 3 | |
Not evaluable, n = 1 | Death after progression, n = 1 | Lymphoma, n = 1 | |
SD/PD, n = 4 | CR, n = 2 | Alive in CR, n = 1 | |
Death in CR, n = 1 | Infection, n = 1 | ||
Death without evaluation, n = 2 | Death, n = 2 | Infection, n = 2 | |
No data, n = 1 | Death without evaluation, n = 1 | Death, n = 1 | MDS, n = 1 |
Univariate Analysis | ||||
---|---|---|---|---|
Characteristics | 3y-PFS (95% CI) | p | 3y-OS (95% CI) | p |
Age at alloSCT: | ||||
<59 | 45% (28–62) | 44.6% (27.4–61.8) | ||
>60 | 30% (16.9–76.9) | 0.86 | 30% (16.8–76.8) | 0.75 |
Previous lines of therapy: | ||||
1–3 | 39.5% (16.4–62.6) | 39.5% (16.4–62.7) | ||
>3 | 47.4% (24.9–69.9) | 0.95 | 46.80% | 0.95 |
Previous ASCT: | ||||
Yes | 56.4% (35.8–77) | 56.4% (36–77) | ||
No | 21.4% (0.2–43) | 0.06 | 21.4% (0.1–43) | 0.13 |
Conditioning regimen: | ||||
MAC | 20% (4.7–44.7) | 20% (5–45) | ||
RIC | 52.7% (33.9–71.5) | 0.04 | 52% (33–71) | 0.04 |
Donor: | ||||
Sibling | 52% (30.3–73.5) | 51.6% (29.8–73.4) | ||
Haploidentical | 57% (20.4–93.8) | 57% (20.4–93.8) | ||
Unrelated | 25% (5–55) | 0.3 | 25% (5–55) | 0.22 |
Response pre alloSCT: | ||||
CR | 61% (39.9–82.3) | 66.7% (46.5–86.9) | ||
Other | 23.4% (1.8–45) | 0.06 | 22.5% (1–44) | 0.11 |
aGVHD: | ||||
Yes | 41.5% (22.3–60.7) | 41% (21.5–60.3) | ||
No | 53% (22.6–83.4) | 0.66 | 53% (22.6–83.4) | 0.67 |
aGVHD: | ||||
0–2 | 47% (46.8–47.2) | 46.5% (27.4–63.8) | ||
>2 | 33.3% (31.9–33.7) | 0.9 | 33.3% (4.3–70.9) | 0.65 |
cGVHD: | ||||
Yes | 75% (50.5–99.5) | 75% (50.5–99.5) | ||
No | 32% (13.8–50.2) | 0.008 | 32% (13.8–50.2) | 0.008 |
Reference | Patients (n) | CR (%) | OS/PFS (%) | NRM (%) |
---|---|---|---|---|
Heinzelman et al., J. Cancer Res. Clin. Oncol. 2018 [24] | 33 | 62% | 1-y: 49/33 2-y: 39/30 5-y: 33/24 | 30-d: 9 100-d: 25 1-y: 38 2-y: 43 |
Rezvani et al., Clin. Oncol. 2008 [29] | 16 | - | 3-y OS: 43 3-y PFS: 38 | 3-y: 42 |
Villa et al., Clin. Oncol. 2013 [13] | 22 | 59% | 5-y OS: 45 | 5-y: 23 |
Wirk et al., BBMT 2014 PMID: 24641828 [30] | 33 | - | 5-y: 22/18 | 1-y: 41 |
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Rey-Búa, B.; Cabrero, M.; Bento, L.; Montoro, J.; Bastos-Oreiro, M.; Parody, R.; Yañez, L.; Lopez-Godino, O.; Zanabili, J.; Herrera, P.; et al. Allogeneic Hematopoietic Stem Cell Transplantation in Transformed Follicular Lymphoma (tFL): Results of a Retrospective Multicenter Study from GELTAMO/GETH-TC Spanish Groups. Cancers 2022, 14, 5670. https://doi.org/10.3390/cancers14225670
Rey-Búa B, Cabrero M, Bento L, Montoro J, Bastos-Oreiro M, Parody R, Yañez L, Lopez-Godino O, Zanabili J, Herrera P, et al. Allogeneic Hematopoietic Stem Cell Transplantation in Transformed Follicular Lymphoma (tFL): Results of a Retrospective Multicenter Study from GELTAMO/GETH-TC Spanish Groups. Cancers. 2022; 14(22):5670. https://doi.org/10.3390/cancers14225670
Chicago/Turabian StyleRey-Búa, Beatriz, Mónica Cabrero, Leyre Bento, Juan Montoro, Mariana Bastos-Oreiro, Rocío Parody, Lucrecia Yañez, Oriana Lopez-Godino, Joud Zanabili, Pilar Herrera, and et al. 2022. "Allogeneic Hematopoietic Stem Cell Transplantation in Transformed Follicular Lymphoma (tFL): Results of a Retrospective Multicenter Study from GELTAMO/GETH-TC Spanish Groups" Cancers 14, no. 22: 5670. https://doi.org/10.3390/cancers14225670
APA StyleRey-Búa, B., Cabrero, M., Bento, L., Montoro, J., Bastos-Oreiro, M., Parody, R., Yañez, L., Lopez-Godino, O., Zanabili, J., Herrera, P., Gutierrez, G., Perez, A., Piñana, J. L., Novelli, S., Cortés, M., Sureda, A. M., Caballero, D., & García-Sancho, A. M. (2022). Allogeneic Hematopoietic Stem Cell Transplantation in Transformed Follicular Lymphoma (tFL): Results of a Retrospective Multicenter Study from GELTAMO/GETH-TC Spanish Groups. Cancers, 14(22), 5670. https://doi.org/10.3390/cancers14225670