Mohamed A Kharfan-Dabaja1, Tea Reljic2, Hemant S Murthy3, Ernesto Ayala1, Ambuj Kumar4. 1. Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL. 2. Program for Comparative Effectiveness Research, Morsani College of Medicine, University of South Florida, Tampa, FL. 3. Blood and Marrow Transplantation and Malignant Hematology Program, University of Florida Health Cancer Center, Gainesville, FL. 4. Program for Comparative Effectiveness Research, Morsani College of Medicine, University of South Florida, Tampa, FL. Electronic address: akumar1@health.usf.edu.
Abstract
INTRODUCTION: It is common practice to refer patients to transplantation centers for allogeneic hematopoietic cell transplantation (allo-HCT) for blastic plasmacytoid dendritic-cell neoplasm (BPDCN) despite lack of randomized controlled trials. We performed a systematic review to assess the totality of evidence pertaining to the efficacy of allo-HCT in BPDCN. METHODS: We searched the Cochrane, PubMed, and Embase databases through January 5, 2018, for studies on allo-HCT for BPDCN. Two authors independently reviewed all references for inclusion and extracted data related to benefits (overall [OS] and progression-free/disease-free [PFS/DFS] survival) and harms (relapse and nonrelapse mortality) from included studies. When appropriate, data were pooled using random-effects model. RESULTS: Four studies (128 patients) were included in analysis. Pooled OS rate was 50% (95% confidence interval [CI], 41-59) for all patients. Among patients who underwent allografting whose disease was in first complete remission (CR1), pooled OS and PFS/DFS rates were 67% (95% CI, 52-80) and 53% (95% CI, 29-76), respectively. For patients who underwent allografting in > CR1, pooled OS and PFS/DFS rates were 7% (95% CI, 0-32) for both outcomes. Relapse rates were higher when reduced-intensity regimens were used (40% [95% CI, 25-56] vs. 18% [95% CI, 7-31]). CONCLUSION: This systematic review represents the best available evidence supporting allo-HCT in BPDCN, especially when offered in CR1. Use of myeloablative allo-HCT results in lower pooled relapse rates (18% vs. 40%). A prospective comparative study will be needed to determine the impact of intensity of the conditioning regimen on postallograft relapse.
INTRODUCTION: It is common practice to refer patients to transplantation centers for allogeneic hematopoietic cell transplantation (allo-HCT) for blastic plasmacytoid dendritic-cell neoplasm (BPDCN) despite lack of randomized controlled trials. We performed a systematic review to assess the totality of evidence pertaining to the efficacy of allo-HCT in BPDCN. METHODS: We searched the Cochrane, PubMed, and Embase databases through January 5, 2018, for studies on allo-HCT for BPDCN. Two authors independently reviewed all references for inclusion and extracted data related to benefits (overall [OS] and progression-free/disease-free [PFS/DFS] survival) and harms (relapse and nonrelapse mortality) from included studies. When appropriate, data were pooled using random-effects model. RESULTS: Four studies (128 patients) were included in analysis. Pooled OS rate was 50% (95% confidence interval [CI], 41-59) for all patients. Among patients who underwent allografting whose disease was in first complete remission (CR1), pooled OS and PFS/DFS rates were 67% (95% CI, 52-80) and 53% (95% CI, 29-76), respectively. For patients who underwent allografting in > CR1, pooled OS and PFS/DFS rates were 7% (95% CI, 0-32) for both outcomes. Relapse rates were higher when reduced-intensity regimens were used (40% [95% CI, 25-56] vs. 18% [95% CI, 7-31]). CONCLUSION: This systematic review represents the best available evidence supporting allo-HCT in BPDCN, especially when offered in CR1. Use of myeloablative allo-HCT results in lower pooled relapse rates (18% vs. 40%). A prospective comparative study will be needed to determine the impact of intensity of the conditioning regimen on postallograft relapse.
Authors: Justin Taylor; Michael Haddadin; Vivek A Upadhyay; Erwin Grussie; Neha Mehta-Shah; Andrew M Brunner; Abner Louissaint; Scott B Lovitch; Ahmet Dogan; Amir T Fathi; Richard M Stone; Martin S Tallman; Raajit K Rampal; Donna S Neuberg; Kristen E Stevenson; Steven M Horwitz; Andrew A Lane Journal: Blood Date: 2019-06-26 Impact factor: 22.113
Authors: Qaiser Bashir; Denái R Milton; Uday R Popat; Partow Kebriaei; Chitra Hosing; Issa F Khouri; Katayoun Rezvani; Yago Nieto; Betul Oran; Samer A Srour; Neeraj Y Saini; Amanda L Olson; Sairah Ahmed; Gheath Al-Atrash; Gabriela Rondon; Marina Y Konopleva; Richard E Champlin; Elizabeth J Shpall; Muzaffar H Qazilbash; Naveen Pemmaraju Journal: Bone Marrow Transplant Date: 2021-10-11 Impact factor: 5.174