TY - JOUR
T1 - Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure
AU - Smith, Sonali M.
AU - Godfrey, James
AU - Ahn, Kwang Woo
AU - DiGilio, Alyssa
AU - Ahmed, Sairah
AU - Agrawal, Vaibhav
AU - Bachanova, Veronika
AU - Bacher, Ulrike
AU - Bashey, Asad
AU - Bolaños-Meade, Javier
AU - Cairo, Mitchell
AU - Chen, Andy
AU - Chhabra, Saurabh
AU - Copelan, Edward
AU - Dahi, Parastoo B.
AU - Aljurf, Mahmoud
AU - Farooq, Umar
AU - Ganguly, Siddhartha
AU - Hertzberg, Mark
AU - Holmberg, Leona
AU - Inwards, David
AU - Kanate, Abraham S.
AU - Karmali, Reem
AU - Kenkre, Vaishalee P.
AU - Kharfan-Dabaja, Mohamed A.
AU - Klein, Andreas
AU - Lazarus, Hillard M.
AU - Mei, Matthew
AU - Mussetti, Alberto
AU - Nishihori, Taiga
AU - Ramakrishnan Geethakumari, Praveen
AU - Saad, Ayman
AU - Savani, Bipin N.
AU - Schouten, Harry C.
AU - Shah, Nirav
AU - Urbano-Ispizua, Alvaro
AU - Vij, Ravi
AU - Vose, Julie
AU - Sureda, Anna
AU - Hamadani, Mehdi
N1 - Publisher Copyright:
© 2018 American Cancer Society
PY - 2018/6/15
Y1 - 2018/6/15
N2 - BACKGROUND: Early treatment failure (ETF) in follicular lymphoma (FL), defined as relapse or progression within 2 years of frontline chemoimmunotherapy, is a newly recognized marker of poor survival and identifies a high-risk group of patients with an expected 5-year overall survival (OS) rate of approximately 50%. Transplantation is an established option for relapsed FL, but its efficacy in this specific ETF FL population has not been previously evaluated. METHODS: This study compared autologous hematopoietic stem cell transplantation (auto-HCT) with either matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic hematopoietic cell transplantation (allo-HCT) as the first transplantation approach for patients with ETF FL (age ≥ 18 years) undergoing auto-HCT or allo-HCT between 2002 and 2014. The primary endpoint was OS. The secondary endpoints were progression-free survival, relapse, and nonrelapse mortality (NRM). RESULTS: Four hundred forty FL patients had ETF (auto-HCT, 240; MSD hematopoietic stem cell transplantation [HCT], 105; and MUD HCT, 95). With a median follow-up of 69 to 73 months, the adjusted probability of 5-year OS was significantly higher after auto-HCT (70%) or MSD HCT (73%) versus MUD HCT (49%; P =.0008). The 5-year adjusted probability of NRM was significantly lower for auto-HCT (5%) versus MSD (17%) or MUD HCT (33%; P <.0001). The 5-year adjusted probability of disease relapse was lower with MSD (31%) or MUD HCT (23%) versus auto-HCT (58%; P <.0001). CONCLUSIONS: Patients with high-risk FL, as defined by ETF, undergoing auto-HCT for FL have low NRM and a promising 5-year OS rate (70%). MSD HCT has lower relapse rates than auto-HCT but similar OS. Cancer 2018;124:2541-51.
AB - BACKGROUND: Early treatment failure (ETF) in follicular lymphoma (FL), defined as relapse or progression within 2 years of frontline chemoimmunotherapy, is a newly recognized marker of poor survival and identifies a high-risk group of patients with an expected 5-year overall survival (OS) rate of approximately 50%. Transplantation is an established option for relapsed FL, but its efficacy in this specific ETF FL population has not been previously evaluated. METHODS: This study compared autologous hematopoietic stem cell transplantation (auto-HCT) with either matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic hematopoietic cell transplantation (allo-HCT) as the first transplantation approach for patients with ETF FL (age ≥ 18 years) undergoing auto-HCT or allo-HCT between 2002 and 2014. The primary endpoint was OS. The secondary endpoints were progression-free survival, relapse, and nonrelapse mortality (NRM). RESULTS: Four hundred forty FL patients had ETF (auto-HCT, 240; MSD hematopoietic stem cell transplantation [HCT], 105; and MUD HCT, 95). With a median follow-up of 69 to 73 months, the adjusted probability of 5-year OS was significantly higher after auto-HCT (70%) or MSD HCT (73%) versus MUD HCT (49%; P =.0008). The 5-year adjusted probability of NRM was significantly lower for auto-HCT (5%) versus MSD (17%) or MUD HCT (33%; P <.0001). The 5-year adjusted probability of disease relapse was lower with MSD (31%) or MUD HCT (23%) versus auto-HCT (58%; P <.0001). CONCLUSIONS: Patients with high-risk FL, as defined by ETF, undergoing auto-HCT for FL have low NRM and a promising 5-year OS rate (70%). MSD HCT has lower relapse rates than auto-HCT but similar OS. Cancer 2018;124:2541-51.
KW - allogeneic transplantation
KW - autologous transplantation
KW - chemoimmunotherapy
KW - early treatment failure
KW - follicular lymphoma
KW - rituximab
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U2 - 10.1002/cncr.31374
DO - 10.1002/cncr.31374
M3 - Article
C2 - 29645093
AN - SCOPUS:85045242474
SN - 0008-543X
VL - 124
SP - 2541
EP - 2551
JO - Cancer
JF - Cancer
IS - 12
ER -