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Allogeneic transplantation provides durable remission in a subset of DLBCL patients relapsing after autologous transplantation
Author(s) -
Fenske Timothy S.,
Ahn Kwang W.,
Graff Tara M.,
DiGilio Alyssa,
Bashir Qaiser,
Kamble Rammurti T.,
Ayala Ernesto,
Bacher Ulrike,
Brammer Jonathan E.,
Cairo Mitchell,
Chen Andy,
Chen YiBin,
Chhabra Saurabh,
D'Souza Anita,
Farooq Umar,
Freytes Cesar,
Ganguly Siddhartha,
Hertzberg Mark,
Inwards David,
Jaglowski Samantha,
KharfanDabaja Mohamed A.,
Lazarus Hillard M.,
Nathan Sunita,
Pawarode Attaphol,
Perales MiguelAngel,
Reddy Nishitha,
Seo Sachiko,
Sureda Anna,
Smith Sonali M.,
Hamadani Mehdi
Publication year - 2016
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.14046
Subject(s) - medicine , transplantation , oncology , multivariate analysis , hematopoietic cell , hematopoietic stem cell transplantation , lymphoma , haematopoiesis , stem cell , biology , genetics
Summary For diffuse large B‐cell lymphoma ( DLBCL ) patients progressing after autologous haematopoietic cell transplantation (auto HCT ), allogeneic HCT (allo HCT ) is often considered, although limited information is available to guide patient selection. Using the Center for International Blood and Marrow Transplant Research ( CIBMTR ) database, we identified 503 patients who underwent allo HCT after disease progression/relapse following a prior auto HCT . The 3‐year probabilities of non‐relapse mortality, progression/relapse, progression‐free survival ( PFS ) and overall survival ( OS ) were 30, 38, 31 and 37% respectively. Factors associated with inferior PFS on multivariate analysis included Karnofsky performance status ( KPS ) <80, chemoresistance, auto HCT to allo HCT interval <1‐year and myeloablative conditioning. Factors associated with worse OS on multivariate analysis included KPS <80, chemoresistance and myeloablative conditioning. Three adverse prognostic factors were used to construct a prognostic model for PFS , including KPS <80 (4 points), auto HCT to allo HCT interval <1‐year (2 points) and chemoresistant disease at allo HCT (5 points). This CIBMTR prognostic model classified patients into four groups: low‐risk (0 points), intermediate‐risk (2‐5 points), high‐risk (6‐9 points) or very high‐risk (11 points), predicting 3‐year PFS of 40, 32, 11 and 6%, respectively, with 3‐year OS probabilities of 43, 39, 19 and 11% respectively. In conclusion, the CIBMTR prognostic model identifies a subgroup of DLBCL patients experiencing long‐term survival with allo HCT after a failed prior auto HCT .