I El-Najjar1, A Boumendil2, J J Luan2, R Bouabdallah3, K Thomson4, M Mohty5, P Colombat6, P Biron7, H Tilly8, M Pfreundschuh9, C Cordonnier10, A Sureda11, J Y Cahn12, J P Vernant13, J Gribben1, G Cook14, A P Haynes15, A Ferrant16, H Finel2, S Montoto17, P Dreger18. 1. Barts, London, UK. 2. EBMT LWP Office, Paris. 3. Institute Paoli Calmettes, University de la Méditerranée, Marseille, France. 4. Department of Haematology, University College London Hospitals, London, UK. 5. INSERM, UMRs 938, Paris Clinical Hematology and Cellular Therapy, Hospital Saint-Antoine, APHP, Paris University Pierre et Marie Curie, Paris. 6. Hematology and Cellular Therapy, CHU Bretonneau, Tours. 7. Centre Leon Berard, Lyon. 8. Department of Hematology, Centre Henri Becquerel, University of Rouen, Rouen. 9. Department of Internal Medicine I, Saarland University Medical School, Homburg, Germany. 10. Department of Hematology, Henri Mondor University Hospital, Creteil, France. 11. Department of Hematology, Addenbrooke's Hospital, Cambridge University, Cambridge, UK. 12. Department of Hematology, University Hospital Grenoble. 13. APHP-Pitié Salpétrière, UPMC Universite Paris 6, Paris, France. 14. St James's Institute of Oncology, St James's University Hospital, Leeds. 15. Nottingham University Hospital, Nottingham, UK. 16. Department of Hematology, University Hospital Saint-Luc, Catholic University Louvain, Brussels, Belgium. 17. Barts, London, UK EBMT LWP Office, Paris. 18. EBMT LWP Office, Paris Department of Medicine V, University of Heidelberg, Heidelberg, Germany peter.dreger@med.uni-heidelberg.de.
Abstract
BACKGROUND: The aim of this study was to investigate the impact of the high-dose regimen on the outcome of patients with follicular lymphoma (FL) having had autologous stem-cell transplantation (ASCT) in a recent time period. PATIENTS: Between 1995 and 2007, 2233 patients with FL had their first ASCT with either a total body irradiation (TBI)-containing regimen or carmustin, etoposide, cytarabine and melphalan (BEAM), of which 47% were autografted in first remission. RESULTS: After a median observation time of 73 months (interquartile range 30-107), 5- and 10-year non-relapse mortality (NRM) was similar (6% and 10% in both groups). No significant NRM differences became evident after multivariate adjustment for confounders. Secondary malignancies were observed in 9.7% and 7.9% of the patients after TBI and BEAM (P = 0.19), which were treatment-related myelodysplastic syndromes/acute myelogenous leukaemia (t-MDS/AML) in 3.4% and 2.8% (P = 0.57). The median time to t-MDS/AML was around 50 months in both groups. Because of a lower relapse incidence, TBI was associated with better event-free survival reaching statistical significance in the patients transplanted in first remission but not in those transplanted beyond first remission. CONCLUSIONS: In patients with FL who received TBI-based ASCT after 1995 increased NRM and t-MDS/AML risks did not emerge compared with BEAM while disease control was at least equivalent.
BACKGROUND: The aim of this study was to investigate the impact of the high-dose regimen on the outcome of patients with follicular lymphoma (FL) having had autologous stem-cell transplantation (ASCT) in a recent time period. PATIENTS: Between 1995 and 2007, 2233 patients with FL had their first ASCT with either a total body irradiation (TBI)-containing regimen or carmustin, etoposide, cytarabine and melphalan (BEAM), of which 47% were autografted in first remission. RESULTS: After a median observation time of 73 months (interquartile range 30-107), 5- and 10-year non-relapse mortality (NRM) was similar (6% and 10% in both groups). No significant NRM differences became evident after multivariate adjustment for confounders. Secondary malignancies were observed in 9.7% and 7.9% of the patients after TBI and BEAM (P = 0.19), which were treatment-related myelodysplastic syndromes/acute myelogenous leukaemia (t-MDS/AML) in 3.4% and 2.8% (P = 0.57). The median time to t-MDS/AML was around 50 months in both groups. Because of a lower relapse incidence, TBI was associated with better event-free survival reaching statistical significance in the patients transplanted in first remission but not in those transplanted beyond first remission. CONCLUSIONS: In patients with FL who received TBI-based ASCT after 1995 increased NRM and t-MDS/AML risks did not emerge compared with BEAM while disease control was at least equivalent.
Authors: L Bento; A Boumendil; H Finel; S Le Gouill; S Amorim; H Monjanel; R Bouabdallah; J O Bay; E Nicolas-Virelizier; G McQuaker; G Rossi; R Johnson; A Huynh; P Ceballos; A Rambaldi; E Bachy; R Malladi; K Orchard; D Pohlreich; H Tilly; F Bonifazi; X Poiré; F Guilhot; A Haenel; C Crawley; B Metzner; J Gribben; N H Russell; G Damaj; K Thomson; P Dreger; S Montoto Journal: Bone Marrow Transplant Date: 2017-05-22 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: 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
Authors: Mattias Carlsten; Martin Jädersten; Anna Hellström; Karin Littmann; Christopher M Melén; Henna Riikka Junlén; Kristina Sonnevi; Per Ljungman; Bo Björkstrand; Björn Engelbrekt Wahlin Journal: Exp Hematol Oncol Date: 2019-03-18