The role of autologous stem cell transplantation (ASCT) in patients with marginal zone lymphoma (MZL) is debatable. This study investigated the outcome and prognostic factors affecting the outcome of patients undergoing ASCT for MZL. Eligible patients had non-transformed nodal, extra-nodal (MALT) or splenic MZL (SMZL), aged ≥18 years, who underwent a first ASCT between1994 and 2013 and were reported to the European Society for Blood and Marrow Transplantation, Fondazione Italiana Linfomi or Gruppo Italiano Trapianto Di Midollo Osseo registries. The study included 199 patients, [111 MALT lymphoma, 55 nodal MZL (NMZL) and 33 SMZL]. Median age at transplantation was 56 years. The median number of prior therapies was 2 (range 1-8), including rituximab in 71%. 95% had chemosensitive disease. 89% received a chemotherapy-based high-dose regimen. There were no significant differences in patient and transplant characteristics between the 3 histological subtypes except for a lower percentage of patients previously treated with rituximab in the MALT sub-group and more transplants performed in recent years in the other sub-groups. After a median follow-up of 5 years, 5-year cumulative incidence of relapse/progression and non-relapse mortality were 38% and 9%, respectively. Five-year event-free survival (EFS) and overall survival (OS) were 53% and 73%, respectively. Five-year cumulative incidence of second malignancies was 6%. Multivariate analysis revealed age ≥65 years was associated with a shorter EFS and OS. In addition, patients with SMZL had a shorter OS than those with MALT. ASCT may provide clinical benefit in MZL patients who have failed multiple lines of chemoimmunotherapy.

APHP INSERM U 728 Institut Universitaire d'Hematologie Hopital Saint Louis Paris France

Brest University Hospital Brest France

Centre Léon Bérard Lyon France

Charles University Hospital Prague Czech Republic

CHU d'Angers Angers France

CHU de Dijon Hospital `Le Bocage` Dijon France

Département d'Onco Hématologie Institut Paoli Calmettes Marseille France

Department of Haemato Oncology St Bartholomew's Hospital Barts Health NHS Trust London UK

Department of Internal Medicine 1 Saarland University Medical School Homburg Saar Germany

Department of Medicine Huddinge H7 Unit for Hematology M 54 Karolinska Universitetssjukhuset Huddinge Stockholm Sweden

Division of Medical Oncology Istituto Nazionale dei Tumori Milan Italy

DRMM University of Udine Udine Italy

EBMT LWP Paris Office Hôpital Saint Antoine Paris France

GMMG Germany Cologne Germany

Inserm U935 CHU de Poitiers Poitiers France

Institut Gustave Roussy Villejuif France

Institute of Hematology University of Catania Catania Italy

IRCCS Fondazione Policlinico San Matteo Pavia Italy

Kliniken Essen Süd Essen Germany

Klinikum Chemnitz gGmbH Chemnitz Germany

Midizinische Klinik und Poliklinik 1 Universitaetsklinikum Dresden Dresden Germany

National Institutes of Health National Cancer Institute Bethesda MD USA

Oncoematologia e TMO Palermo Italy

Ospedale degli Infermi Biella Italy

Tel Aviv Sourasky Medical Centre Tel Aviv Israel

Universita Di Pavia IRCCS Fondazione San Matteo Pavia Italy

University Hospital of Saarland Homburg Germany

University Hospital Pilsen Czech Republic

University Hospital Schleswig Holstein Kiel Germany

University of Heidelberg Heidelberg Germany

University of Kiel Kiel Germany

References provided by Crossref.org