Frank Heinzelmann1, Wolfgang Bethge2, Dietrich Wilhelm Beelen3, Matthias Stelljes4, Peter Dreger5, Marianne Engelhard6, Jürgen Finke7, Nikolaus Kröger8, Ernst Holler9, Martin Bornhäuser10, Annerose Müller11, Imme Haubitz12, Hellmut Ottinger3. 1. Department of Radiation Oncology, University Hospital (UH) of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany. frank.heinzelmann@med.uni-tuebingen.de. 2. Department of Internal Medicine II, University Hospital of Tübingen, Tübingen, Germany. 3. Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, Germany. 4. Department of Bone Marrow Transplantation, University Hospital of Münster, Münster, Germany. 5. Department of Medicine V, University Hospital of Heidelberg, Heidelberg, Germany. 6. Department of Radiotherapy, University Hospital of Essen, Essen, Germany. 7. Department of Hematology and Oncology, University Hospital of Freiburg, Freiburg, Germany. 8. Clinic for Stem Cell Transplantation, University Hospital of Hamburg (UKE), Hamburg, Germany. 9. Department of Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany. 10. Department of Internal Medicine I, University Hospital of Dresden, Dresden, Germany. 11. Department of Radiation Oncology, University Hospital (UH) of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany. 12. Data Processing Center, University of Würzburg, Würzburg, Germany.
Abstract
PURPOSE: In patients with follicular lymphoma, secondary transformation to aggressive lymphoma (tFL) implies a poor prognosis. In principle, allogeneic haematopoietic cell transplantation (allo-HCT) offers a chance of cure for tFL but is rarely practiced. Aim of this retrospective multicenter study was to define the actual significance of allo-HCT in treatment of tFL. METHODS: The database of the German Registry for Stem Cell Transplantation (DRST) was screened for patients who underwent allo-HCT for tFL 1998-2008. Confirmation of tFL-diagnosis by local and/or pathologists of the National NHL Board was mandatory for enrolment. Gaps in reported EBMT Minimum Essential Data datasets (MED-A) were filled by local DRST data managers. Relevant HCT outcome variables were evaluated by uni- and multivariate statistical analysis. RESULTS: Median age of enrolled 33 patients was 51 years with a post allo-HCT median follow-up of 7.1 years of surviving patients. At time of HCT 24/33 patients had chemosensitive disease. In 24/33 patients reduced intensity conditioning (RIC) was used. Estimated 1, 2, 5-year overall survival (OS) and event-free survival rates were 49/39/33, and 33/30/24%. Cumulative 100 days non-relapse mortality was 25%. Chemosensitive disease, RIC, and limited chronic GvHD were identified as independent prognostic factors for OS. CONCLUSIONS: Allo-HCT offers the chance of cure for tFL.
PURPOSE: In patients with follicular lymphoma, secondary transformation to aggressive lymphoma (tFL) implies a poor prognosis. In principle, allogeneic haematopoietic cell transplantation (allo-HCT) offers a chance of cure for tFL but is rarely practiced. Aim of this retrospective multicenter study was to define the actual significance of allo-HCT in treatment of tFL. METHODS: The database of the German Registry for Stem Cell Transplantation (DRST) was screened for patients who underwent allo-HCT for tFL 1998-2008. Confirmation of tFL-diagnosis by local and/or pathologists of the National NHL Board was mandatory for enrolment. Gaps in reported EBMT Minimum Essential Data datasets (MED-A) were filled by local DRST data managers. Relevant HCT outcome variables were evaluated by uni- and multivariate statistical analysis. RESULTS: Median age of enrolled 33 patients was 51 years with a post allo-HCT median follow-up of 7.1 years of surviving patients. At time of HCT 24/33 patients had chemosensitive disease. In 24/33 patients reduced intensity conditioning (RIC) was used. Estimated 1, 2, 5-year overall survival (OS) and event-free survival rates were 49/39/33, and 33/30/24%. Cumulative 100 days non-relapse mortality was 25%. Chemosensitive disease, RIC, and limited chronic GvHD were identified as independent prognostic factors for OS. CONCLUSIONS: Allo-HCT offers the chance of cure for tFL.
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