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Outcome in patients with diffuse large B-cell lymphoma who relapse after autologous stem cell transplantation and receive active therapy. A retrospective analysis of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation (EBMT)
E. González-Barca, A. Boumendil, D. Blaise, M. Trněný, T. Masszi, H. Finel, MG. Michieli, JT. Bittenbring, G. Gritti, JA. Snowden, M. Bishton, B. Bruno, SG. de Villambrosia, A. Janikova, X. Leleu, A. Anagnostopoulos, X. Poiré, M. Crysandt, ZN....
Language English Country Great Britain
Document type Journal Article
NLK
Free Medical Journals
from 1997 to 1 year ago
Freely Accessible Science Journals
from 1997 to 1 year ago
ProQuest Central
from 2000-01-01 to 1 year ago
Open Access Digital Library
from 1997-01-01
Health & Medicine (ProQuest)
from 2000-01-01 to 1 year ago
- MeSH
- Transplantation, Autologous MeSH
- Lymphoma, Large B-Cell, Diffuse * therapy MeSH
- Adult MeSH
- Bone Marrow MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local MeSH
- Disease-Free Survival MeSH
- Prospective Studies MeSH
- Retrospective Studies MeSH
- Hematopoietic Stem Cell Transplantation * MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Autologous hematopoietic stem cell transplantation (auto-HSCT) is the standard of care for patients with diffuse large B-cell lymphoma (DLBCL) who relapse/progress after first line chemoimmunotherapy. Long-term outcome of those who relapse after transplant is poor. We present the results of a retrospective study of 256 adult patients reported to the EBMT registry with DLBCL who relapsed after auto-HSCT performed between 2003 and 2013, and who received active salvage strategies. One hundred and fifty-four (60%) were male; median age was 53 years. Median time to relapse was 7 months, 65% relapsed during the first year. Overall response rate after salvage therapy was 46%. Median follow-up after first salvage therapy was 40 months (IQR 23-63 months). Overall survival (OS) at 3 years was 27% (95% CI 22-33). OS at 3 years of patients relapsing longer than 1 year after auto-HSCT was 41% (95% CI 31-53) compared with 20% (95% CI 14-24) in those who relapsed in less than 1 year. Eighty-two patients (32%) had a second HSCT, an allogeneic HSCT (allo-HSCT) in 69 cases, at a median time of 6.5 months after relapse. OS at 3 years after allo-HSCT was 36% (95% CI 25-51). In conclusion, the prognosis of patients with DLBCL that relapse after auto-HSCT is dismal. Patients who relapse in less than 1 year remain an unmet need, and should be considered for CAR T cell therapy or clinical trials. Patients who relapse after 1 year can be rescued with salvage therapies and a second HSCT. These results provide a benchmark to compare data of new prospective studies.
1st Charles University General Hospital Prague Czech Republic
Centro di Riferimento Oncologico Aviano Italy
Department of Hematology and Oncology University Hospital Brno Brno Czech Republic
Department of Hematology Hopital A Michallon Grenoble FRA France
Department of Hematology Hospital Universitario Marqués de Valdecilla Santander Spain
Department of Hematology Nottingham University Hospitals NHS Trust Nottingham UK
Department of Hematology University Hospital Gasthuisberg Dept of Hematology Leuven Belgium
Department of Medicine 5 University of Heidelberg Heidelberg Germany
Department of Medicine Kuopio University Hospital Kuopio Finland
EBMT Paris Study Office Paris France
Gazi University Faculty of Medicine Ankara Turkey
Haemato Oncology Department St Bartholomew's Hospital Barts Health NHS Trust London UK
Hematology Department and HCT Unit G Papanikolaou Hospital Thessaloniki Greece
Hospital de la Santa Creu i Sant Pau Clinical Hematology Service Barcelona Spain
Institut Català d'Oncologia Hospital Duran i Reynals IDIBELL Barcelona Spain
Institut Paoli Calmettes Department of Hematology Marseille France
Papa Giovanni XXIII Hospital Bergamo Italy
Section of Hematology Cliniques Universitaires Saint Luc Brussels Belgium
Service D'Hématologie Et Thérapie Cellulaire Hopital de La Milétrie Poitiers France
Sheffield Teaching Hospitals Sheffield UK
Siunsote North Carelia Hospital District Joensuu Finland
St István and St Laszlo Hospital Budapest Hungary
St James Hospital and Trinity College Dublin Dublin Ireland
Turku University Hospital Stem Cell Transplantation Unit Turku Finland
University of Antwerp Antwerp University Hospital Dept of Hematology Antwerp Belgium
University of Eastern Finland Institute of Clinical Medicine Internal Medicine Kuopio Finland
References provided by Crossref.org
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