Autologous and allogeneic stem-cell transplantation for transformed follicular lymphoma: a report of the Canadian blood and marrow transplant group
| Autor: | John Kuruvilla, Khaled M. Ramadan, Joseph M. Connors, Diego Villa, Michael Crump, Christina Lee, David MacDonald, Anargyros Xenocostas, Cynthia L. Toze, Rena Buckstein, Mohsen Alzahrani, Alexandra Muccilli, Ronan Foley, Douglas A. Stewart, Sandra Cohen, Morel Rubinger, Félix Couture, Jean-François Larouche, Kerry J. Savage, Tony Panzarella, Kimberley Ambler, Mitchell Sabloff, Neil Chua, Abdulwahab J. Al-Tourah |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty medicine.medical_treatment Follicular lymphoma Antineoplastic Agents Transplantation Autologous Disease-Free Survival Cohort Studies Antibodies Monoclonal Murine-Derived Internal medicine medicine Humans Transplantation Homologous Lymphoma Follicular Chemotherapy business.industry Middle Aged medicine.disease Surgery Lymphoma Transplantation Cell Transformation Neoplastic Treatment Outcome Monoclonal Multivariate Analysis Rituximab Female Stem cell business Cohort study medicine.drug Stem Cell Transplantation |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 31(9) |
| ISSN: | 1527-7755 |
| Popis: | Purpose To determine whether autologous (auto) or allogeneic (allo) stem-cell transplantation (SCT) improves outcome in patients with transformed follicular lymphoma compared with rituximab-containing chemotherapy alone. Patients and Methods This was a multicenter cohort study of patients with follicular lymphoma and subsequent biopsy-proven aggressive histology transformation. Patient, treatment, and outcome data were collected from each transplantation center and combined for analysis. A separate control group was composed of patients with transformation treated with rituximab-containing chemotherapy but not SCT. The primary end point was overall survival (OS) after transformation. Results One hundred seventy-two patients were identified: 22 (13%) treated with alloSCT, 97 (56%) with autoSCT, and 53 (31%) with rituximab-containing chemotherapy. Five-year OS after transformation was 46% for patients treated with alloSCT, 65% with autoSCT, and 61% with rituximab-containing chemotherapy (P = .24). Five-year progression-free survival (PFS) after transformation was 46% for those treated with alloSCT, 55% with autoSCT, and 40% with rituximab-containing chemotherapy (P = .12). In multivariate analysis, patients treated with autoSCT had improved OS compared with those who received rituximab-containing chemotherapy (hazard ratio [HR], 0.13; 95% CI, 0.05 to 0.34; P < .001). On the other hand, there was no OS difference between those treated with alloSCT and rituximab-containing chemotherapy (HR, 0.44; 95% CI, 0.16 to 1.24; P = .12). OS and PFS after SCT were similar between those treated with autoSCT and alloSCT. Five-year transplantation-related mortality was 23% for those treated with alloSCT and 5% for autoSCT. Conclusion Patients undergoing autoSCT had better outcomes than those treated with rituximab-containing chemotherapy alone. AlloSCT did not improve outcome compared with rituximab-containing chemotherapy and was associated with clinically significant toxicity. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|