BACKGROUND: Stem cell transplant (SCT)-related outcomes and prognostication for relapsed/refractory follicular lymphoma (FL) are not well-defined in the post-rituximab era. METHODS: Through the National Comprehensive Cancer Network (NCCN) lymphoma outcomes study, 184 patients with relapsed/refractory FL who underwent autologous SCT (autoSCT) or allogenic SCT (alloSCT) following disease relapse after prior rituximab-based therapy were examined. RESULTS: Patients who underwent autoSCT (N=136) were older compared with patients who underwent alloSCT (N=48) (54 versus 51 years, respectively, P=.01) and more frequently had grade 3 FL (35% versus 8%, respectively, P=.006). Patients who underwent alloSCT received more prior therapies (4 versus 3, respectively, P<.0001) and more often had resistant disease at SCT (19% versus 6%, respectively, P=.008). Cumulative 100-day nonrelapse mortality (NRM) for autoSCT and alloSCT were 1% and 6%, respectively (P<.0001), whereas 3-year NRM rates were 3% versus 24%, respectively (P<.0001). For autoSCT and alloSCT, cumulative rates of relapse, progression, and/or transformation were 32% versus 16%, respectively (P=.03), whereas 3-year overall survival rates were 87% versus 61% (P<.0001); there were no differences in failure-free survival. AlloSCT was associated with increased risk of death on multivariate analysis (hazard ratio=2.77, 95% confidence interval=1.46-5.26, P=.002). This finding persisted on propensity scoring/matching. Multivariate analysis for autoSCT patients identified age>60 years and>3 prior therapies as adverse factors. Furthermore, a survival model was created for the autoSCT cohort based on number of factors present (0, 1, 2); 3-year failure-free survival was 72%, 47%, and 20%, respectively (P=.0003), and 3-year overall survival was 96%, 82%, and 62%, respectively (P<.0001). CONCLUSIONS: AutoSCT remains an effective therapy for patients with FL. For alloSCT, continued strategies to reduce NRM are needed.
BACKGROUND: Stem cell transplant (SCT)-related outcomes and prognostication for relapsed/refractory follicular lymphoma (FL) are not well-defined in the post-rituximab era. METHODS: Through the National Comprehensive Cancer Network (NCCN) lymphoma outcomes study, 184 patients with relapsed/refractory FL who underwent autologous SCT (autoSCT) or allogenic SCT (alloSCT) following disease relapse after prior rituximab-based therapy were examined. RESULTS:Patients who underwent autoSCT (N=136) were older compared with patients who underwent alloSCT (N=48) (54 versus 51 years, respectively, P=.01) and more frequently had grade 3 FL (35% versus 8%, respectively, P=.006). Patients who underwent alloSCT received more prior therapies (4 versus 3, respectively, P<.0001) and more often had resistant disease at SCT (19% versus 6%, respectively, P=.008). Cumulative 100-day nonrelapse mortality (NRM) for autoSCT and alloSCT were 1% and 6%, respectively (P<.0001), whereas 3-year NRM rates were 3% versus 24%, respectively (P<.0001). For autoSCT and alloSCT, cumulative rates of relapse, progression, and/or transformation were 32% versus 16%, respectively (P=.03), whereas 3-year overall survival rates were 87% versus 61% (P<.0001); there were no differences in failure-free survival. AlloSCT was associated with increased risk of death on multivariate analysis (hazard ratio=2.77, 95% confidence interval=1.46-5.26, P=.002). This finding persisted on propensity scoring/matching. Multivariate analysis for autoSCT patients identified age>60 years and>3 prior therapies as adverse factors. Furthermore, a survival model was created for the autoSCT cohort based on number of factors present (0, 1, 2); 3-year failure-free survival was 72%, 47%, and 20%, respectively (P=.0003), and 3-year overall survival was 96%, 82%, and 62%, respectively (P<.0001). CONCLUSIONS: AutoSCT remains an effective therapy for patients with FL. For alloSCT, continued strategies to reduce NRM are needed.
Authors: Amrita Y Krishnan; Joycelynne Palmer; Auayporn P Nademanee; Robert Chen; Leslie L Popplewell; Ni-Chun Tsai; James F Sanchez; Jennifer Simpson; Ricardo Spielberger; Dave Yamauchi; Stephen J Forman Journal: Biol Blood Marrow Transplant Date: 2017-03-04 Impact factor: 5.742
Authors: S Yano; T Mori; Y Kanda; J Kato; C Nakaseko; S Fujisawa; N Tomita; R Sakai; K Shono; T Saitoh; N Aotsuka; N Kobayashi; T Saito; S Takahashi; H Kanamori; S Okamoto Journal: Bone Marrow Transplant Date: 2015-07-13 Impact factor: 5.483
Authors: F Heinzelmann; W Bethge; D W Beelen; M Engelhard; N Kröger; P Dreger; D Niederwieser; J Finke; D Bunjes; J Tischer; G Kobbe; E Holler; M Bornhäuser; M Stelljes; H Baurmann; A Müller; I Haubitz; H Schrezenmeier; C Müller; H Ottinger Journal: Bone Marrow Transplant Date: 2016-02-08 Impact factor: 5.483
Authors: Evgeny Klyuchnikov; Ulrike Bacher; Nicolaus M Kröger; Parameswaran N Hari; Kwang Woo Ahn; Jeanette Carreras; Veronika Bachanova; Asad Bashey; Jonathon B Cohen; Anita D'Souza; César O Freytes; Robert Peter Gale; Siddhartha Ganguly; Mark S Hertzberg; Leona A Holmberg; Mohamed A Kharfan-Dabaja; Andreas Klein; Grace H Ku; Ginna G Laport; Hillard M Lazarus; Alan M Miller; Alberto Mussetti; Richard F Olsson; Shimon Slavin; Saad Z Usmani; Ravi Vij; William A Wood; David G Maloney; Anna M Sureda; Sonali M Smith; Mehdi Hamadani Journal: Biol Blood Marrow Transplant Date: 2015-08-04 Impact factor: 5.742
Authors: Timothy S Fenske; Mehdi Hamadani; Jonathon B Cohen; Luciano J Costa; Brad S Kahl; Andrew M Evens; Paul A Hamlin; Hillard M Lazarus; Effie Petersdorf; Christopher Bredeson Journal: Biol Blood Marrow Transplant Date: 2016-04-27 Impact factor: 5.742
Authors: Carla Casulo; Jonathan W Friedberg; Kwang W Ahn; Christopher Flowers; Alyssa DiGilio; Sonali M Smith; Sairah Ahmed; David Inwards; Mahmoud Aljurf; Andy I Chen; Hannah Choe; Jonathon Cohen; Edward Copelan; Umar Farooq; Timothy S Fenske; Cesar Freytes; Sameh Gaballa; Siddhartha Ganguly; Yogesh Jethava; Rammurti T Kamble; Vaishalee P Kenkre; Hillard Lazarus; Aleksandr Lazaryan; Richard F Olsson; Andrew R Rezvani; David Rizzieri; Sachiko Seo; Gunjan L Shah; Nina Shah; Melham Solh; Anna Sureda; Basem William; Aaron Cumpston; Andrew D Zelenetz; Brian K Link; Mehdi Hamadani Journal: Biol Blood Marrow Transplant Date: 2017-12-11 Impact factor: 5.742