Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure Journal Article


Authors: Smith, S. M.; Godfrey, J.; Ahn, K. W.; DiGilio, A.; Ahmed, S.; Agrawal, V.; Bachanova, V.; Bacher, U.; Bashey, A.; Bolaños-Meade, J.; Cairo, M.; Chen, A.; Chhabra, S.; Copelan, E.; Dahi, P. B.; Aljurf, M.; Farooq, U.; Ganguly, S.; Hertzberg, M.; Holmberg, L.; Inwards, D.; Kanate, A. S.; Karmali, R.; Kenkre, V. P.; Kharfan-Dabaja, M. A.; Klein, A.; Lazarus, H. M.; Mei, M.; Mussetti, A.; Nishihori, T.; Ramakrishnan Geethakumari, P.; Saad, A.; Savani, B. N.; Schouten, H. C.; Shah, N.; Urbano-Ispizua, A.; Vij, R.; Vose, J.; Sureda, A.; Hamadani, M.
Article Title: Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure
Abstract: BACKGROUND: Early treatment failure (ETF) in follicular lymphoma (FL), defined as relapse or progression within 2 years of frontline chemoimmunotherapy, is a newly recognized marker of poor survival and identifies a high-risk group of patients with an expected 5-year overall survival (OS) rate of approximately 50%. Transplantation is an established option for relapsed FL, but its efficacy in this specific ETF FL population has not been previously evaluated. METHODS: This study compared autologous hematopoietic stem cell transplantation (auto-HCT) with either matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic hematopoietic cell transplantation (allo-HCT) as the first transplantation approach for patients with ETF FL (age ≥ 18 years) undergoing auto-HCT or allo-HCT between 2002 and 2014. The primary endpoint was OS. The secondary endpoints were progression-free survival, relapse, and nonrelapse mortality (NRM). RESULTS: Four hundred forty FL patients had ETF (auto-HCT, 240; MSD hematopoietic stem cell transplantation [HCT], 105; and MUD HCT, 95). With a median follow-up of 69 to 73 months, the adjusted probability of 5-year OS was significantly higher after auto-HCT (70%) or MSD HCT (73%) versus MUD HCT (49%; P =.0008). The 5-year adjusted probability of NRM was significantly lower for auto-HCT (5%) versus MSD (17%) or MUD HCT (33%; P <.0001). The 5-year adjusted probability of disease relapse was lower with MSD (31%) or MUD HCT (23%) versus auto-HCT (58%; P <.0001). CONCLUSIONS: Patients with high-risk FL, as defined by ETF, undergoing auto-HCT for FL have low NRM and a promising 5-year OS rate (70%). MSD HCT has lower relapse rates than auto-HCT but similar OS. Cancer 2018;124:2541-51. © 2018 American Cancer Society. © 2018 American Cancer Society
Keywords: rituximab; follicular lymphoma; allogeneic transplantation; autologous transplantation; chemoimmunotherapy; early treatment failure
Journal Title: Cancer
Volume: 124
Issue: 12
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2018-06-15
Start Page: 2541
End Page: 2551
Language: English
DOI: 10.1002/cncr.31374
PROVIDER: scopus
PMCID: PMC5990449
PUBMED: 29645093
DOI/URL:
Notes: Article -- Export Date: 2 July 2018 -- Source: Scopus
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MSK Authors
  1. Parastoo Bahrami Dahi
    78 Dahi