Outcomes of Hematopoietic Cell Transplantation for Diffuse Large B Cell Lymphoma Transformed from Follicular Lymphoma

• Type of Material: Article
• Authors: Baldeep Wirk, Stony Brook University; Timothy S. Fenske, Medical College of Wisconsin; Mehdi Hamadani, West Virginia University Hospitals; Mei-Jie Zhang, Medical College of Wisconsin; Zhen-Huan Hu, Medical College of Wisconsin; Gorgun Akpek, Banner MD Anderson Cancer Center; Mahmoud D. Aljurf, King Faisal Specialist Hospital Center & Research; Philippe Armand, Dana Farber Cancer Institute; Ernesto Ayala, H. Lee Moffitt Cancer Center and Research Institute; Verniko Bachanova, University of Minnesota Medical Center; Brian Bolwell, Cleveland Clinic; Mitchell S. Cairo, New York Medical College; Amanda Cashen, Barnes Jewish Hospital; Yi-Bin Chen, Massachusetts General Hospital; Luciano J. Costa, Medical University of South Carolina; Shatha Farhan, Henry Ford Hospital; Cesar O. Freytes, South Texas Veterans Health Care System; James L. Gajewski, Oregon Health and Science University; John Gibson, Royal Prince Alfred Hospital; Edmund K Waller, Emory University
• Language: English
• Date: 2014-07-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 American Society for Blood and Marrow Transplantation.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.bbmt.2014.03.014
• Title of Journal or Parent Work: Biology of Blood and Marrow Transplantation
• ISSN: 1083-8791
• Volume: 20
• Issue: 7
• Start Page: 951
• End Page: 959
• Grant/Funding Information: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24 CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement U10 HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-12-1-0142 and N00014-13-1-0039 from the Office of Naval Research; and grants from Allos Therapeutics, Inc.; Amgen, Inc.; Anonymous donation to the Medical College of Wisconsin; Ariad; Be the Match Foundation; Blue Cross and Blue Shield Association; Celgene Corporation; Fresenius-Biotech North America, Inc.; Gamida Cell Teva Joint Venture Ltd.; Genentech, Inc.;Gentium SpA; Genzyme Corporation; GlaxoSmithKline; HistoGenetics, Inc.; Kiadis Pharma; The Leukemia & Lymphoma Society; The Medical College of Wisconsin; Merck & Co, Inc.; Millennium: The Takeda Oncology Co.; Milliman USA, Inc.; Miltenyi Biotec, Inc.; National Marrow Donor Program; Onyx Pharmaceuticals; Optum Healthcare Solutions, Inc.; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; Remedy Informatics; Sanofi US; Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc.; StemCyte, A Global Cord Blood Therapeutics Co.; Stemsoft Software, Inc.; Swedish Orphan Biovitrum; Tarix Pharmaceuticals; TerumoBCT; Teva Neuroscience, Inc.; THERAKOS, Inc.; and Wellpoint, Inc.
• Keywords: Transplant; BLOOD; Science & Technology; SUBTYPE; HISTOLOGICAL TRANSFORMATION; SUPPORT; Immunology; FLUDARABINE; lymphoma; RISK; HIGH-DOSE THERAPY; Transformed follicular; Hematology; Life Sciences & Biomedicine; LOW-GRADE; NON-HODGKINS-LYMPHOMA; Transplantation
• Research Categories: Health Sciences, Oncology; Health Sciences, Medicine and Surgery

Abstract

There are limited data on the outcomes of autologous or allogeneic hematopoietic cell transplantation (HCT) in diffuse large B cell lymphoma transformed from follicular lymphoma. We analyzed transplantation outcomes in 141 subjects with biopsy-proven diffuse large B-cell lymphoma transformed from follicular lymphoma reported to the Center for International Blood and Marrow Transplant Research between 1990 and 2009. Two groups were identified: autologous HCT (auto-HCT; n = 108) and allogeneic HCT (allo-HCT; n = 33). Fewer auto-HCTs were done for transformed follicular lymphoma in 2003 to 2009, with a shift favoring allo-HCT. Auto-HCT was associated with a 1-year nonrelapse mortality (NRM) of 8% (95% confidence interval [CI], 4% to 14%), 5-year progression-free survival of 35% (95% CI, 26% to 45%), and 5-year overall survival of 50% (95% CI, 40% to 59%). In contrast, allo-HCT was associated with a 1-year NRM of 41% (95% CI, 23% to 58%), 5-year progression-free survival of 18% (95% CI, 6% to 35%), and 5-year overall survival of 22% (95% CI, 8% to 41%). Auto-HCT for transformed follicular lymphoma achieves sustained remission in a high proportion of subjects. The high NRM of allo-HCT offset any benefit that might be associated with this transplantation modality.