Favorable outcomes from allogeneic and autologous stem cell transplantation for patients with transformed nonfollicular indolent lymphoma.

Autor: Villa D; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; British Columbia Cancer Agency, Vancouver, British Columbia, Canada. Electronic address: dvilla@bccancer.bc.ca., George A; Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia., Seymour JF; Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia., Toze CL; Leukemia/Bone Marrow Transplant Program of British Columbia, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada., Crump M; Princess Margaret Cancer Centre, Toronto, Ontario, Canada., Lee C; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Buckstein R; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Stewart DA; Tom Baker Cancer Centre, Calgary, Alberta, Canada., MacDonald D; Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada., Foley R; Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada., Xenocostas A; London Health Sciences Centre, London, Ontario, Canada., Sabloff M; The Ottawa Hospital, Ottawa, Ontario, Canada., Chua N; Cross Cancer Institute, Edmonton, Alberta, Canada., Couture F; Hotel Dieu de Quebec, Quebec City, Quebec, Canada., Larouche JF; Hôpital de l'enfant Jesus, Quebec City, Quebec, Canada., Cohen S; Maisonneuve Rosemont Hôpital, Montreal, Quebec, Canada., Savage KJ; British Columbia Cancer Agency, Vancouver, British Columbia, Canada., Connors JM; British Columbia Cancer Agency, Vancouver, British Columbia, Canada., Panzarella T; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada., Carney DA; Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia., Dickinson M; Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia., Kuruvilla J; Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2014 Nov; Vol. 20 (11), pp. 1813-8. Date of Electronic Publication: 2014 Jul 18.
DOI: 10.1016/j.bbmt.2014.07.015
Abstrakt: The role of allogeneic (allo-) and autologous stem cell transplantation (auto-SCT) in the management of patients with transformed indolent nonfollicular non-Hodgkin lymphoma is unknown. This is a multicenter, retrospective cohort study of patients with biopsy-proven indolent B cell nonfollicular non-Hodgkin lymphoma and simultaneous or subsequent biopsy-proven aggressive histology transformation who were treated with allo-SCT or auto-SCT between 1996 and 2013. All patients received myeloablative conditioning regimens. Outcomes were compared with a cohort of 246 patients with transformed follicular lymphoma who also underwent allo-SCT (n = 47) or auto-SCT (n = 199) across the same institutions and time frame. Thirty-four patients were identified with the following underlying indolent histologies: 15 (44%) marginal zone lymphoma, 11 (32%) chronic lymphocytic leukemia, 6 (18%) small lymphocytic lymphoma, and 2 (6%) lymphoplasmacytic lymphoma. Patients received various anthracycline or platinum-containing chemotherapy regimens for transformation, incorporating rituximab in 25 (74%). Twelve (35%) subsequently underwent allo-SCT, whereas 33 (65%) underwent auto-SCT. The 3-year overall survival rate after transplantation was 67% (allo-SCT 54%, auto-SCT 74%), and 3-year progression-free survival rate was 49% (allo-SCT 40%, auto-SCT 54%). The 3-year nonrelapse mortality rate was 14% (allo-SCT 15%, auto-SCT 7%). Transplant-related mortality at 100 days was 17% for allo-SCT and 0% for auto-SCT. Adjusted for type of stem cell transplantation, 3-year overall survival, progression-free survival, and nonrelapse mortality rates were similar to those of patients with transformed follicular lymphoma receiving allo-SCT and auto-SCT (P = .38, P = .69, and P = .54, respectively). Allo-SCT and auto-SCT may be reasonable treatments for selected patients with transformed nonfollicular indolent lymphoma, although medium-term outcomes and toxicity appear to be more favorable with auto-SCT.
(Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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