Autologous stem cell transplantation for post-transplant lymphoproliferative disorders after solid organ transplantation: a retrospective analysis from the Lymphoma Working Party of the EBMT
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články
PubMed
33864020
PubMed Central
PMC8410594
DOI
10.1038/s41409-021-01270-5
PII: 10.1038/s41409-021-01270-5
Knihovny.cz E-zdroje
- MeSH
- autologní transplantace MeSH
- difúzní velkobuněčný B-lymfom * MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- lymfoproliferativní nemoci * etiologie terapie MeSH
- retrospektivní studie MeSH
- transplantace hematopoetických kmenových buněk * škodlivé účinky MeSH
- transplantace kmenových buněk MeSH
- transplantace orgánů * škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Published data describing the efficacy and safety of autologous stem-cell transplantation (autoSCT) in post-transplant lymphoproliferative disorders (PTLD) is limited to case reports. This is a retrospective analysis of 21 patients reported to the EBMT registry who received an autoSCT for PTLD post solid organ transplant (SOT). Median age at autoSCT was 47 (range: 22-71) years. The commonest SOTs were kidney (48%) and liver (24%). Commonest histologies included DLBCL-type PTLD (14/21) and plasmacytoma-like PTLD (3/21). Patients received a median of two lines of therapy (range: 1-4) pre-autoSCT. ECOG performance status pre-autoSCT was 0 in 14% and 1 in 86%. Remission status pre-autoSCT was CR 47% and PR 38%. BEAM conditioning was used in 57% and high-dose melphalan in 10%. The median follow-up post-autoSCT was 64 months for alive patients. 3-year PFS was 62% [95% confidence interval (CI) 44-87%] and 3-year OS was 61% [95% CI:43-86]. There were 12 deaths, including four related to autoSCT. 100-day non-relapse-mortality (NRM) was 14% and 1-year NRM was 24%. This study suggests that autoSCT, although feasible and with potential therapeutic activity, is associated with a high NRM, primarily driven by infectious toxicity. A multi-disciplinary approach, expert microbiological input and stringent patient selection are required to optimise outcomes.
BMT Unit University Hospital Bristol NHS Foundation Trust Bristol UK
Department of Haemato oncology St Bartholomew's Hospital Barts Health NHS Trust London UK
Department of Haematology Addenbrookes Hospital Cambridge UK
Department of Haematology Charles University Hospital Prague Czech Republic
Department of Haematology Ghent University Hospital Ghent Belgium
Department of Haematology Hammersmith Hospital London UK
Department of Haematology Hospices Civils Lyon France
Department of Haematology Hospital Center University of Caen Caen Normandy France
Department of Haematology Jena University Hospital Jena Germany
Department of Haematology Kantonsspital Aarau Switzerland
Department of Haematology Western General Hospital Edinburgh UK
Department of Hematology and Oncology Charité Universitätsmedizin Berlin Berlin Germany
Department of Hematology and Oncology DIAKO Ev Diakonie Krankenhaus Bremen Bremen Germany
Erasmus Hospital Route de Lennik 808 1070 Bruxelles Belgium
Lymphoma Working Party EBMT Paris France
Manchester Royal Infirmary Oxford Road Manchester UK
Nephrology Transplantation Department Strasbourg University Hospitals Strasbourg France
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