Outcome in patients with diffuse large B-cell lymphoma who relapse after autologous stem cell transplantation and receive active therapy. A ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-09-20

AUTHORS

E. González-Barca, A. Boumendil, D. Blaise, M. Trněný, T. Masszi, H. Finel, M. G. Michieli, J. T. Bittenbring, G. Gritti, J. A. Snowden, M. Bishton, B. Bruno, S. González de Villambrosia, A. Janikova, X. Leleu, A. Anagnostopoulos, X. Poiré, M. Crysandt, Z. N. Özkurt, E. Vandenberghe, M. Itälä-Remes, J. Y. Cahn, E. Jantunen, W. Schroyens, J. Maertens, A. Esquirol, P. Dreger, S. Montoto, A. Sureda

ABSTRACT

Autologous hematopoietic stem cell transplantation (auto-HSCT) is the standard of care for patients with diffuse large B-cell lymphoma (DLBCL) who relapse/progress after first line chemoimmunotherapy. Long-term outcome of those who relapse after transplant is poor. We present the results of a retrospective study of 256 adult patients reported to the EBMT registry with DLBCL who relapsed after auto-HSCT performed between 2003 and 2013, and who received active salvage strategies. One hundred and fifty-four (60%) were male; median age was 53 years. Median time to relapse was 7 months, 65% relapsed during the first year. Overall response rate after salvage therapy was 46%. Median follow-up after first salvage therapy was 40 months (IQR 23–63 months). Overall survival (OS) at 3 years was 27% (95% CI 22–33). OS at 3 years of patients relapsing longer than 1 year after auto-HSCT was 41% (95% CI 31–53) compared with 20% (95% CI 14–24) in those who relapsed in less than 1 year. Eighty-two patients (32%) had a second HSCT, an allogeneic HSCT (allo-HSCT) in 69 cases, at a median time of 6.5 months after relapse. OS at 3 years after allo-HSCT was 36% (95% CI 25–51). In conclusion, the prognosis of patients with DLBCL that relapse after auto-HSCT is dismal. Patients who relapse in less than 1 year remain an unmet need, and should be considered for CAR T cell therapy or clinical trials. Patients who relapse after 1 year can be rescued with salvage therapies and a second HSCT. These results provide a benchmark to compare data of new prospective studies. More... »

PAGES

393-399

Journal

TITLE

Bone Marrow Transplantation

ISSUE

2

VOLUME

55

Author Affiliations

  • Institut Català d’Oncologia, Hospital Duran i Reynals, IDIBELL, Barcelona, Spain
  • EBMT Paris Study Office, Paris, France
  • Institut Paoli Calmettes, Department of Hematology, Marseille, France
  • 1st Charles University General Hospital, Prague, Czech Republic
  • St. István and St. Laszlo Hospital, Budapest, Hungary
  • Centro di Riferimento Oncologico, Aviano, Italy
  • University of Saarland, Homburg, Germany
  • Papa Giovanni XXIII Hospital, Bergamo, Italy
  • Sheffield Teaching Hospitals, Sheffield, UK
  • Department of Hematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
  • Department of Molecular Biotechnology and Health Sciences, AOU Città della Salute e della Scienza, University of Torino, Torino, Italy
  • Department of Hematology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
  • Department of Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
  • Service D’Hématologie Et Thérapie Cellulaire, Hopital de La Milétrie, Poitiers, France
  • Hematology Department & HCT Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
  • Section of Hematology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
  • Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen University, Aachen, Germany
  • Gazi University Faculty of Medicine, Ankara, Turkey
  • St James Hospital and Trinity College Dublin, Dublin, Ireland
  • Turku University Hospital, Stem Cell Transplantation Unit, Turku, Finland
  • Department of Hematology, Hopital A. Michallon, Grenoble, FRA, France
  • Siunsote—North Carelia Hospital District, Joensuu, Finland
  • University of Antwerp, Antwerp University Hospital, Dept. of Hematology, Antwerp, Belgium
  • Department of Hematology, University Hospital Gasthuisberg, Dept. of Hematology, Leuven, Belgium
  • Hospital de la Santa Creu i Sant Pau, Clinical Hematology Service, Barcelona, Spain
  • Department of Medicine V, University of Heidelberg, Heidelberg, Germany
  • Haemato-Oncology Department, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-019-0650-x

    DOI

    http://dx.doi.org/10.1038/s41409-019-0650-x

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1121125151

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/31541205


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