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 Cancer and Haematology Centre Churchill Hospital Oxford University Hospitals NHS Foundation Trust Oxford 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

Department of Internal Medicine 2 Hematology and Oncology University Medical Centre Schleswig Holstein Campus Kiel Kiel 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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The EHA Research Roadmap: Malignant Lymphoid Diseases